Patients at a paediatric out-patient clinic. A study with particular reference to psychological and social background factors. II. Earlier contacts with the health service, social background, parents' morbidity, general discussion and recommendations.

Abstract

Psychological factors were considered by the examining physicians to play an important part in 5.2% of approximately 4 000 initial visits to a paediatric clinic. These cases are compared with a matched control group representing the cases where the physicians judged that psychological factors were not involved. As compared with the controls, then a considerably larger proportion of the patients with symptoms associated with psychological factors had a previous history of contacts with child psychiatrists or attendence at the paediatric clinic for problems of a psychological nature. Their parents, the mothers in particular, had a higher frequency of registered sickness for mental-nervous disorders and their families had more frequently been the subject of special social inquiries or assistance. To a large extent the examining paediatrician was unaware of these background conditions. With a better case history and proper follow-up one could probably reduce the number of X-ray examinations, consultations and laboratory tests. Further training and better contacts would be facilitated if members of a children's psychiatric team were stationed within the paediatric clinic.