Drug therapy in child psychiatry: Psychological aspects

Abstract

Summary Drug therapy was found to be a safe and useful addition to psychological measures in the outpatient treatment of children whose disorders ranged from severe schizophrenia to mild behavior disorders. Although the underlying pathology was not removed, the quantitative reduction of disorganizing anxiety helped the forces in the child which were striving for re-integration and active mastery. Drugs also promoted more mature patterns of motility, impulse control and attention. These effects enabled many of the children to learn more constructive ways of coping with their interpersonal problems, and to make better use of their schooling. Drug therapy thus facilitated the psychological aspects of treatment, and accelerated the therapy of many of the children. It also provided some help for children who were too disturbed to be candidates for traditional psychotherapy, or who could not participate in such therapy in the absence of drugs. Drugs were generally accepted by parents and children as simply another way in which the doctor was trying to help the child. The physiological effects of drugs did not interfere with the therapeutic relationships between doctor, child and parent. The regulation of medication introduced additional practical problems and transference complications into these interpersonal relationships, but the management of such problems was no different in principle from the similar problems encountered in the absence of, drugs. To this observer, the added problems seemed amply justified by the ability of medication to increase the help available to seriously disturbed children and to accelerate the treatment of many others.