Kołakowski A, Liwska M, Wolańczyk T
Klinice Psychiatrii Wieku Rozwojowego AM w Warszawie.
Psychiatr Pol. 1996 Mar-Apr;30(2):233-46.
This paper presents contemporary opinions about selective mutism in children, including epidemiology, etiology, clinical features and therapy. This is the first extensive review on this topic in Polish literature. The essential feature of selective mutism is persistent failure to speak in social situations, where speaking is expected (e.g., in school), despite speaking in other situations (e.g., at home). The authors present the diagnostic criteria according do DSM-IV and suggested by other authors. Clinical characteristics of this disorder were also presented, including personality traits and behaviour of mutistic children (different at home and in unfamiliar environment) and comorbidity of selective mutism. Etiology of this disorder seems to be multifactorial. The important etiological factors are: minimal brain dysfunction, somatic or psychological trauma, particularly during the speech development and a family structure, especially the mother-child relation. The authors emphasize that mutism in children is a heterogeneous symptom and present several models of mutism. The paper describes also different methods of treatment (e.g., behavioral, psychodynamic, family therapy and some case reports on pharmacotherapy); and long-term prognosis.
本文介绍了关于儿童选择性缄默症的当代观点,包括流行病学、病因学、临床特征和治疗方法。这是波兰文献中关于该主题的首次广泛综述。选择性缄默症的基本特征是在预期会说话的社交场合(如在学校)持续不说话,尽管在其他场合(如在家中)会说话。作者介绍了根据《精神疾病诊断与统计手册第四版》(DSM-IV)以及其他作者建议的诊断标准。还介绍了该障碍的临床特征,包括缄默儿童的人格特质和行为(在家中和在陌生环境中有所不同)以及选择性缄默症的共病情况。该障碍的病因似乎是多因素的。重要的病因因素包括:轻度脑功能障碍、躯体或心理创伤,尤其是在言语发展过程中,以及家庭结构,特别是母子关系。作者强调儿童缄默症是一种异质性症状,并提出了几种缄默症模型。本文还描述了不同的治疗方法(如行为疗法、心理动力学疗法、家庭疗法以及一些药物治疗的病例报告);以及长期预后。