External incentives for the behavior, such as economic gain, avoiding legal responsibility, or improving physical well-being, are absent. The emergency physician often is confronted with baffling symptoms. Frequently, the child has been taken to many care providers before the diagnosis finally is established. Symptoms are inappropriate or incongruent. Patient has multiple allergies.
Symptoms disappear when parent or caretaker is absent.
In children, one parent, usually the father, is absent during hospitalization. History of sudden infant death syndrome in siblings is noted. Parent is overly attached to patient. General health of patient clashes with results of laboratory tests. Parent shows inordinate concern for feelings of the medical staff.