Current trends in Swiss hospital pediatrics (including pediatric surgery). Increasing importance of collaboration with child psychiatry.

The patients of a general pediatric hospital servicing a representative population are analyzed. 3% of the age group below 16 are admitted, whereof 2/3 as emergencies. The morbidity of boys is distinctly higher than for girls. 1/4 is less than 2 years old. Hospitalization rate for infants is much higher than for older age groups. Surgery slowly outnumbers medicine for inpatients. The most frequent single diagnoses are surgical ones, whereas in medicine diagnoses are scattered over a much broader spectrum. Over 11% of all patients had social, psychosomatic or psychological conflicts significantly contributing to the symptomatology presented, for medicine alone it was one out of five patients! Paternal profession, social failures and family quarrels are important for this cohort. A setting of child psychiatry on a consultant basis should complement the traditional framework of pediatric medicine and surgery; hospital pediatrics can then best offer the necessary structures. The pediatrician's role has to remain central, but additional training is mandatory.