Clinical researchers from the Institute of Child Health and Great Ormond Street Hospital for Children, London, analysed the health outcomes of 23 children, who had been referred between 1997 and 2001.

The children, whose average age was 14, had all been diagnosed with severe abdominal pain, with no obvious organic (physical) cause, which had greatly disrupted their lives.

They had been given the normal battery of tests for severe abdominal pain, including blood samples, ultrasound, and endoscopy, in accordance with clinical guidelines.

Fifteen of the children had already seen between two and seven consultants at the time of referral. Seven parents were subsequently unhappy with the choice of investigations and requested other procedures for which there was no accepted indication. Two families had their requests granted through referral elsewhere.

Twelve families made a formal complaint to the hospital or their MP about some aspect of care.

Despite the fact that psychological factors are known to have a role in this condition, only 13 families accepted referral to psychological services. In 12, a significant degree of family conflict/dysfunction and a lack of insight into the consequences of parental behaviour on illness pattern were evident.

Eleven of these children improved after psychological support and resumed normal activities within a year.

Ten families refused psychological help, and only three of these children eventually improved. In each of these three cases, the families had eventually realised the impact of psychological factors.

The authors suggest that their findings illustrate the dangers of 'healthcare consumerism' in families who lack insight into the derivation of their children's s
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Contact: Emma Dickinson
edickinson@bmj.com
44-207-383-6529
BMJ Specialty Journals
21-Mar-2005