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THE ETIOLOGY & TREATMENT OF CHILDHOOD
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"Edward
S. Hume, M.D., J.D.
General Adult Psychiatry
THE ETIOLOGY & TREATMENT OF CHILDHOOD
Jordan W. Smoller University of Pennsylvania
Childhood is a syndrome which has only recently
begun to receive serious attention from clinicians. The syndrome itself,
however, is not at all recent. As early as the 8th century, the Persian
historian Kidnom made references to "short, noisy creatures," who may well
have been what we now call "children." The treatment of children, however,
was unknown until this century, when so-called "child psychologists" and
"child psychiatrists" became common. Despite this history of clinical neglect,
it has been estimated that well over half of all Americans alive today
have experienced childhood directly (Suess, 1983). In fact, the actual
numbers are probably much higher, since these data are based on self-reports
which may be subject to social desirability biases and retrospective distortion.
The growing acceptance of childhood as a distinct phenomenon is reflected
in the proposed inclusion of the syndrome in the upcoming Diagnostic and
Statistical Manual of Mental Disorders, 4th edition, or DSM-IV, of the
American Psychiatric Association (1990). Clinicians are still in disagreement
about the significant clinical features of childhood, but the proposed
DSM-IV will almost certainly include the following core features:
1. Congenital onset
2. Dwarfism
3. Emotional lability and immaturity
4. Knowledge deficits
5. Legume anorexia
Clinical Features of Childhood
Although the focus of this paper is on the efficacy
of conventional treatment of childhood, the five clinical markers mentioned
above merit further discussion for those unfamiliar with this patient population.
CONGENITAL ONSET
In one of the few existing literature reviews
on childhood, Temple- Black (1982) has noted that childhood is almost always
present at birth, although it may go undetected for years or even remain
subclinical inde"
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