ABSTRACT
OBJECTIVE: The aim was to investigate the association of pretreatment social functioning (12 months before initial presentation) with symptom dimensions and social functioning at 1-year follow-up. METHOD: Fifty-six adolescents, age 14-18, first admitted for early onset psychosis, were evaluated at baseline and 1-year follow-up assessing psychopathology (PANSS), social functioning (Strauss and Carpenter Prognostic Scale), and duration of untreated psychosis (DUP). RESULTS: Adolescents with low pretreatment social functioning were at risk of more severe negative symptoms and lower social functioning at follow-up. Negative symptoms at baseline were less predictive and DUP was not predictive in this sample. CONCLUSION: Results of this study suggest a strong longitudinal inter-relatedness between social functioning and negative symptoms in this age group. An integrative treatment approach including family interventions, social skills training, long-term specialized work/school rehabilitation, and adequate antipsychotic treatment is warranted to improve both, social functioning and negative symptoms.
Subject(s)
Psychotic Disorders , Social Behavior , Adolescent , Age Factors , Demography , Female , Follow-Up Studies , Humans , Male , Predictive Value of Tests , Prospective Studies , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Psychotic Disorders/therapy , Severity of Illness Index , Surveys and Questionnaires , Treatment OutcomeABSTRACT
We present the case of a 16-year-old girl with a 12-year history of trichotillomania and trichotillophagia in combination with mental retardation and early childhood deprivation, all contributing to the growth of a stomach ulcer and an oversized, stomach-shaped trichobezoar which had to be removed by gastrotomy. Included are a discussion of psychodynamic aspects, therapeutic strategies, and significant literature, concluding with a short, historic view on the varieties and therapy of bezoars.
Subject(s)
Bezoars/etiology , Trichotillomania/complications , Trichotillomania/psychology , Adolescent , Bezoars/psychology , Female , Humans , Intellectual Disability/complications , Maternal Deprivation , Stress, Psychological/complicationsABSTRACT
Parents of sick or handicapped children often exhibit strong guilt feelings. These can be justified but equally can be irrational, based on magic, prescientific thinking. However, quite often they have an emotionally stabilising function for the parents. Using clinical examples possible reasons for, and the importance of these parental guilt feelings in coping with the disease are analysed. Suggestions for dealing with these guilt feelings in a differentiated manner are formulated.
Subject(s)
Attitude to Health , Guilt , Parents/psychology , Anger , Attitude to Death , Child , Child Abuse , Disabled Persons/psychology , Genetic Diseases, Inborn/psychology , Humans , Parent-Child Relations , Prognosis , Sick Role , Truth DisclosureABSTRACT
Individual observations lead to the realisation that during endoscopy children may develop such a degree of seemingly unexplainable anxiety that the performance of the examination is considerably prejudiced. We therefore examined 39 children systematically, evaluating them according to fearsome products of their imagination on the one hand and real or warranted anxiety on the other. Adjusted to age the children were tested using drawings, projectional tests and role-playing in addition to interviewing, sometimes of their parents as well. The most prominent expressions of anxiety in conjunction with endoscopy were fear of suffocation; fear of damage to internal organs and, in girls, fear of lesions to a "baby inside". In adolescents problems with prudery became evident. On the basis of our experience we developed a systematic model of psychological preparation for endoscopic examinations.
Subject(s)
Endoscopy/psychology , Proctoscopy/psychology , Adolescent , Age Factors , Anxiety , Child , Child, Preschool , Female , Gastroscopy/psychology , Humans , Interview, Psychological , Male , ShameABSTRACT
Both from the view of the pediatrician (16) and the child analyst (3, 6, 9, 21), and recently, too, by behavioral biologists (15) the emotional aspects of illness and hospitalization have been treated with increasing differentiation. On the other hand there are only few studies regarding the cognitive aspects of the problem, i.e. the concepts children have of their bodies and of illness, which depend on the momentary level of their intellectual development. Children's ideas and fears arising from illness or hospitalization frequently can only be understood with the knowledge of the actual body-image. Therefore we have tried to investigate by interviews and drawings of three- to seven-year-old preschoolers their conceptions of the interior of the body and its function. The sources of these ideas were discussed and some suggestions were made how the results of the study could be used in hospital and kindergarten.
Subject(s)
Body Image , Age Factors , Attitude to Health , Child Development , Child, Preschool , Female , Humans , MaleABSTRACT
The overproportional rate of medical treatment of foreign children in the private practice of paediatricians and in the paediatric hospitals imposes very often special difficulties on our medical care system. These difficulties do not only result from the language barrier but also from the vast difference between the illness concepts of our medical system which bases in natural science, and the traditional concepts of the prescientific medical layman system of the foreign patients. Because of the doctors ignorance in these different cultural forms of understanding, feeling and expression of illness, as well as in the specific attitudes to the body, shown by members--specially women and girls--of the South European an Asia Minor societies, it leads often to deep misunderstandings in the doctor-patient-relation and therefore to false diagnosis and wrong treatment. This should be demonstrated in one case.
Subject(s)
Pain/psychology , Transients and Migrants , Adolescent , Cultural Characteristics , Fear , Female , Germany, West , Humans , Islam , Physician-Patient Relations , Turkey/ethnologyABSTRACT
The increasing importance of radiotherapy in tumor of childhood demands the investigation and consideration of the psychological aspects of this afflicting therapy. In this paper the results obtained by questioning and observing 28 children of different ages, their parents, attendants and employees of several radiological departments are discussed. As the children's fantasies and the resulting anxieties and reactions are depending on the respective intellectual and emotional developmental stage detailed proposals concerning the preparation and performance of radiation in toddlers, school children and adolescents are presented.
