Lamb H R
Hosp Community Psychiatry. 1982 Jun;33(6):465-8. doi: 10.1176/ps.33.6.465.
Young chronic patients are faced with the same concerns and life-cycle stresses as others in their age group. They strive for independence, satisfying relationships, a sense of identity, and a realistic vocational choice. Lacking the ability to withstand stress and intimacy, they struggle and often repeatedly fail. The result is anxiety, depression, psychotic episodes, and hospitalizations; gradually many begin to give up the struggle. Such concerns may become intensified during the reassessment of life that takes place at about age 30. Denial of illness, the rebelliousness of youth, and issues of control and violence compound the problems. Since deinstitutionalization, patients can no longer take asylum from stresses in a lifetime of hospitalization. Many patients drift from one city to another, or from one living situation to another. Some ways of approaching these problems, such as working with younger patients while they may still be motivated to make changes, helping them develop appropriate rationalizations, and supporting realistic goals, are discussed.
年轻的慢性病患者面临着与同龄人相同的担忧和生命周期压力。他们追求独立、令人满意的人际关系、身份认同感以及现实的职业选择。由于缺乏承受压力和亲密关系的能力，他们苦苦挣扎且常常屡战屡败。结果便是焦虑、抑郁、精神病发作以及住院治疗；渐渐地，许多人开始放弃挣扎。在大约30岁时进行的生活重新评估期间，此类担忧可能会加剧。对疾病的否认、年轻人的叛逆以及控制和暴力问题使这些问题更加复杂。自非机构化以来，患者再也无法在终身住院治疗中躲避压力。许多患者从一个城市漂泊到另一个城市，或者从一种生活状况漂泊到另一种生活状况。文中讨论了应对这些问题的一些方法，比如在年轻患者仍有动力做出改变时与他们合作，帮助他们形成适当的自我辩解，并支持现实的目标。
