Monosymptomatic hysteria in childhood, family and professional systems involvement

A conceptual framework for understanding childhood hysteria is presented. A family orientation for evaluating the relative contributions of the child, family and professionals is used, incorporating five previously described psychological concepts (abnormal illness behaviour, identification and imitation, family myths, childhood predicament, locus of control). Three case histories are presented to illustrate the clinical method and to emphasize the need for careful assessment and the avoidance of hastily contrived strategies for treatment. The principles of liaison psychiatry within a paediatric setting previously described in the literature are important factors in the successful management of these families.