Abstract

Concepts of illness and related beliefs and behaviours are often inappropriate to health state. They develop in childhood and we review the processes that are often involved, which are influenced by ethnic, cultural, demographic, social, psychological and biological factors. Unusual patterns of care experienced by some children and the inappropriate illness behaviours of those with particular influence over them play a central part in the development of the most extreme disorders. Prospective studies are limited but indicate that patterns of illness behaviour in childhood are often persistent and continue or recur in adult life. Inappropriate patterns of invalidism are common in children and adults and the poor prognosis, considerable costs and personal distress indicate the need for primary prevention as well as more active intervention for those who are at particular risk.

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