Alderton H R
Can Med Assoc J. 1971 Jan 23;104(2):127-32.
Most latency children referred to the non-psychiatric physician with behaviour disorders do not suffer from classical neuroses, brain syndrome, retardation or psychoses. In evaluating the significance of disturbance two questions must be answered. I. Does the child have significant symptoms? This requires assessment of parental objectivity, knowledge of normal development, familiarity with developmental tasks of the period and ability to draw conclusions from observations of the child. II. How disturbed is the child? Here the basic questions are: 1. To what extent are the difficulties reactive to current stress rather than internalized? 2. How serious are the symptoms themselves? Criteria for answering these questions are provided. Comments are made on history-taking and a guide to the clinical examination is presented, together with findings indicating whether the disturbance is mild or serious. Principles for rational intervention are discussed and various treatment options are examined. Methods relatively economical of the physician's time are indicated unless clear reasons for more intensive treatment are present. If very definite improvement has not taken place within six months, psychiatric consultation should be sought.
大多数因行为障碍而被转介给非精神科医生的潜在期儿童，并不患有典型的神经症、脑综合征、发育迟缓或精神病。在评估障碍的重要性时，必须回答两个问题。一、孩子是否有明显症状？这需要评估家长的客观性、对正常发育的了解、对该时期发育任务的熟悉程度以及从对孩子的观察中得出结论的能力。二、孩子的受干扰程度如何？这里的基本问题是：1. 这些困难在多大程度上是对当前压力的反应而非内在化的？2. 症状本身有多严重？文中提供了回答这些问题的标准。对病史采集进行了评论，并给出了临床检查指南，同时还给出了表明障碍是轻度还是严重的检查结果。讨论了合理干预的原则，并审视了各种治疗选择。除非有更强化治疗的明确理由，否则指出了相对节省医生时间的方法。如果六个月内没有出现非常明显的改善，应寻求精神科会诊。
