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The general practitioner's important role as a counsellor on sexual matters is stressed. The psychosexual development of an individual is discussed. Some neglected conditions where family counselling may be required are presented, together with suggestions for the management of the sexual aspects of chronic illnesses and conditions.
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This article reviews the literature concerning psychological characteristics of adolescents with idiopathic scoliosis. Although much has been written on the topic, it is largely based on clinical judgment rather than empirical data. In spite of methodological flaws, the few empirical studies available raise questions regarding the following issues: maladjustment occurs in a significant number of adolescents with scoliosis; there are sex and age differences in response to scoliosis diagnosis and treatment; and noncompliance is a major factor in treatment. Implications for further research are discussed.
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Seven cases who developed paroxysm during adolescence and/or in a special situation were selected and subjected for studies of the existing pattern of the patients and also of the paroxysmal situation in relation to their individual life history. (1) "Schlafepilepsie" and psychomotor seizure were identified as being the pattern of epilepsy that developed exceedingly in a situational dependent fashion. (2) An intensive linkage between the patients and their parents was observed. (3) A forced separation from their parents allows to radicalize their conflicts. (4) Their existence is compounded further by the situation where their intrinsic order is compelled to change, and control of themselves becomes difficult to maintain. (5) This process permits the revelation of a latent process of epilepsy.
The psychiatric complications occurring during the three stages of labour are described, together with those factors which predispose to delivery-room complications or abnormalities. The predisposing factors include conflicts in relation to feminine identity, repressed traumatic experiences during the early stages of psychosexual development, adverse social, educational and economic situation, and excessive fear and anxiety, particularly in the absence of support from the husband. The triad of fear-tension-pain, the influence of socio-economic and cultural factors, and the methods utilized to reduce both anxiety and fear are discussed. The interrelation between environmental, hormonal and psychological manifestations in the postpartum period is briefly described, with specific emphasis on depression.
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In 8 children with ambiguous external genitals, sex chromosome, hormonal and histological examinations were performed. On this basis the registered sex and the surname of the child were changed from the registered male to female in 3 cases and from female to male in one case. Diagnosis and the decision about the gender are urgent tasks, since prolonged waiting may have serious consequences in psychosexual development.
A discussion of "The Psychodynamics of a Beating Fantasy," by Wayne Myers, M. D. Freud's concepts in "A Child is Being Beaten" (1919) require some revision. The fantasy may involve both parents, with the confusion of sexual identity as an additional significant element. Further, there are similarities between the phenomenon of child battering and the dynamics of Dr. Myer's patient. Also, a significant question is that while beating fantasies are probably universal among children, why do only a small number of adults have them occupy a central role in their psychosexual development and fantasy life?
The demographic stability of the Swiss Canton of Geneva provided us with the necessary conditions for a follow-up study of the entire childhood population who, having consulted the Child Psychiatry Services between 1963 and 1967, later consulted the adult public psychiatric services (720 cases). We looked for specific clusters of clinical signs which would enable us to differentiate, statistically speaking, the groups of children according to their adult diagnosis. We present here the results for the group of children who were diagnosed at adulthood as drug addicts (DSM III R). We found a specific cluster significantly differentiating these children from the other populations. It includes: a personality disorder (undifferentiated behaviour, and solitary and aggressive behaviour), environmental factors (monoparental, rejecting family) and a lack of mental deficiency.
This article highlights the essence of the new theories concerning the development of girls and women. The discussion centers on the implications for reinterpretation of women's actual lives, women's mental health, and the conduct of outpatient psychotherapy with adolescent girls and women.
Anorexia and bulimia nervosa are eating disorders characterised by abnormal eating behaviour, a morbid concern over body weight and a distorted perception of body size. It commonly occurs in young postpubertal girls in developed societies. Aetiological factors are a complex interplay of biological, psychological and social factors. Bizarre eating patterns can lead to life-threatening medical situations which require urgent in-hospital care. Comprehensive management should be effected by a multi-disciplinary team with contributions from the internist, the psychiatrist, the nurse, the psychologist, the social worker and the teacher. There is significant psychiatric morbidity and mortality in the outcome of these eating disorders.
The following study analyzes the preliminary data obtained during a 4 year longitudinal study of 108 diabetic and 107 healthy youths. It was investigated whether chronically ill youths have a more negative body image of themselves than do healthy ones. Further it was studied whether the objective degree of maturity and the quality of the metabolic adjustment of the disease influenced the physical self image of the chronically ill youths. Diabetics were found to view their body as less efficient, underdeveloped and sexually less differentiated, for example. Menarche and pollarche were also viewed negatively. Poor metabolic control of the disease was accompanied by an especially poor physical self image of these young people. Sex related differences in the self image of youths were found only in the control group. Differences in sex are evidently neutralized by the factor disease.
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