Finch S M
Int J Psychiatry Med. 1975;6(1-2):213-25. doi: 10.2190/WB9J-X63E-0JXU-4HTT.
Psychosomatic disorders in children and and adolescents is a topic that covers a wide variety of illnesses and one which is difficult if not impossible to define accurately. In general, chronic emotional states, often nonspecific, serve as strong contributors to the development of a physical illness. The particular illness is often dictated by varying degrees of biological predisposition in one physiological system-i.e., such a predisposition in the respiratory system may lead to asthma or in the gastrointestinal system to ulcerative colitis. In some cases the biological factor is large and the emotional factor minimal, while in other cases the reverse is true. In the early days of research in psychosomatic disorders it was widely believed that each disorder was accompanied by certain specific emotional problems. Further study has shown this is not true. It was also felt that many, if not most of these disorders could be cured by psychotherapy, and this also has proven to be a fallacy. we have moved more and more to the team approach. Since both psyche and soma are involved, more than one specialist is usually required. In children and adolescents this may involve a child psychiatrist, a pediatrician, an allergist or gastroenterologist, a social worker and a psychologist. It requires time and patience to form an effective and smoothly functioning team in which all members respect one another's potential contribution. Some examples of team operation are presented and some of the problems outlined. In addition, there is attention given to the special problems of the adolescent and also the child with chronic nonspecific physical complaints as well as the child who requires hospitalization.
儿童和青少年的心身疾病是一个涵盖多种病症的主题，也是一个即便并非不可能、但也很难准确定义的主题。一般来说，慢性情绪状态，通常不具有特异性，是导致身体疾病的重要因素。具体的疾病往往由一个生理系统中不同程度的生物易感性决定——例如，呼吸系统的这种易感性可能导致哮喘，而胃肠道系统的易感性可能导致溃疡性结肠炎。在某些情况下，生物因素占主导，情绪因素最小，而在其他情况下则相反。在心身疾病研究的早期，人们普遍认为每种疾病都伴有某些特定的情绪问题。进一步的研究表明事实并非如此。人们还认为，这些疾病中的许多（如果不是大多数的话）都可以通过心理治疗治愈，而这也已被证明是一种谬误。我们越来越多地采用团队治疗方法。由于心理和身体都涉及其中，通常需要不止一位专家。对于儿童和青少年，这可能涉及儿童精神科医生、儿科医生、过敏症专科医生或胃肠病学家、社会工作者和心理学家。要形成一个所有成员都尊重彼此潜在贡献的高效且运作顺畅的团队，需要时间和耐心。文中给出了一些团队协作的实例，并概述了一些问题。此外，还关注了青少年的特殊问题，以及有慢性非特异性身体不适的儿童和需要住院治疗的儿童的问题。
