The contribution of the paediatrician and psychiatrist to the management of the child, adolescent and his family--a paediatrician's viewpoint.

An overview highlighting the important contribution of the paediatrician to the psychological care of his patients and their families is presented. He is expected to be competent in his role of diagnosing and managing the physical disorders of his patients; in addition, the complete paediatrician needs to acquire skills in assessing and treating primary developmental and behavioural disorders, and in preventing and managing secondary emotional difficulties which may arise because of minor or major physical illness. The paediatrician may work in collaboration with the psychiatrist in managing children with psychosomatic disorders, and refer directly to the psychiatrist those children with psychoses and conduct disorders. For the rest, especially those who present with somatic symptomatology without organic findings, the psychologically minded paediatrician needs to understand the symptom and the child within the context of his family. Such an understanding may enable the paediatrician to treat the child himself or alternatively prepare his patient for a psychiatric referral, if appropriate. Issues of training of the paediatrician in the acquisition of these listening skills are discussed, emphasizing the additional need for self-directed independent learning. The important preventive role of the paediatrician is emphasized.