Problem:
A 12-year-old girl is hospitalized with severe abdominal pain that has not responded to numerous medications. The comprehensive evaluation, including blood tests and imaging, has been normal. The patient's mother was noted to be very cooperative with medical personnel, but when a psychiatric consultation was requested, the mother was very unhappy and stopped the consultation after 5 minutes. Investigation revealed that the patient and her mother had been seen in various emergency departments around the country over the past several years. After separating the mother from the patient for several hours, the patient began to improve. Which of the following is the most likely diagnosis? • A. Body dysmorphic disorder • B. Factitious disorder imposed on another (Munchausen by proxy) • C. Conversion disorder • D. Drug withdrawal