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The persistent parent.

¹Department of Pediatrics, Tulane University School of Medicine, New Orleans, La 70112.

American Journal of Diseases of Children (1960)

|June 1, 1992

Summary

This summary is machine-generated.

Parental persistence in seeking medical care for a child should align with the child's actual illness. When parental actions and child's condition mismatch, a second diagnosis, like anxiety or Munchausen syndrome by proxy, may be needed.

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Area of Science:

Pediatric Medicine
Medical Diagnosis
Psychological Factors in Health

Background:

Parental involvement is crucial in pediatric healthcare.
Assessing the congruence between parental persistence and a child's illness is essential for accurate diagnosis.
The concept of 'first diagnosis' (the child's condition) and 'second diagnosis' (the reason for seeking care) is key.

Observation:

Parental persistence can be congruent or incongruent with a child's diagnosed morbidity.
Incongruent persistence warrants investigation into potential parental symptom falsification.
A 'persistence algorithm' is proposed to systematically evaluate these discrepancies.

Findings:

The relationship between parental persistence and child morbidity hinges on the initial diagnosis.

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When incongruence is identified, a secondary diagnosis must be considered, ranging from maternal anxiety to Munchausen syndrome by proxy.

The presented algorithm aids in identifying and managing such complex cases.

Implications:

This diagnostic approach has broad applicability in pediatrics.
It highlights the importance of considering parental psychological factors in pediatric illness evaluations.
Accurate diagnosis requires evaluating both the child's condition and the parental motivation for seeking care.