A 9-year-old male patient referred by a pediatrician for evaluation of multiple complaints after dismissing organic pathology exhaustively.
The mother reported that her child had difficulties speaking, had lost weight, was dizzy, had abdominal pain, was sure she had a rare disease and that she certainly needed "some biopsies".
She had practically a book with all the emergency reports, hospitalizations and visits to the pediatrics, gastroenterology, neurology, pediatric urology and child care; she wasn't constantly reminding herself of the need for psychiatric care.
The boy remained silent at all times, silent, aphatic, with monosyllables only when the mother asked him about the symptoms he supposedly had.
It was impossible to evaluate it separately, causing this the complaints of the mother who said she was not an ignorant because she had worked as a secretary in a medical center and knew what she said.
When asked about the child, she said everything was in the reports.
Within the background, the patient lived with a 35-year-old mother (the father visited them every 3 months) and 1 14-year-old brother had no history of psychiatric admissions or previous contact with psychiatry and psychology.
Both pregnancy and psychomotor development were normal.
From the age of 6 years she began to have continuous visits to the emergency room due to multiple and nonspecific symptoms (abdominal pain, dizziness, headaches, loss of consciousness, etc.), and almost always was discharged.
The patient was admitted at 7 and 8 years of age due to supposed hematuria and loss of consciousness respectively.
During the first admission, both the physical examination, laboratory tests and evolution were normal, not presenting the supposed hematuria.
The mother was described as problematic, requiring more tests before discharge.
At the end, urography and cystoscopy were performed, which were also negative.
The second admission (due to loss of knowledge) had the same pattern, with normal laboratory tests, CT and MRI.
After reviewing the reports, they were released to contact the pediatrician.
Consultation with the pediatrician: the pediatrician reported that the mother often went to the consultation with her child for nonspecific symptoms that did not correspond to any diagnosis, complained that analytical tests and/or invasive tests were performed on her child.
She never let her son be evaluated alone, and she dominated some medical terms.
During admission, she was initially very cooperative with the doctors, staying all day in the hospital and even having children discharged or cared for other patients, but her attitude changed when she said everything was normal.
The mother had a history of multiple complaints and visits to the emergency room that remitted after the birth of her child, she had always refused to go to the psychiatrist.
Again, the mother was told that she had to go because she had no support from anyone, that her husband had never taken care of her son, and that she certainly needed a C.T.
She tried to ask her more about her son's history, but she repeated that everything was in the reports.
When I asked him if we could assess him alone, he got angry and went out.
He insisted that it was necessary to come back, but he never returned.
