title: 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.
mesh_terms: D000293:Adolescent; D005191:Family Characteristics; D005260:Female; D006801:Humans; D010044:Outpatient Clinics, Hospital; D010290:Parents; D010372:Pediatrics; D011602:Psychophysiologic Disorders / Q000453:epidemiology*; D012959:Socioeconomic Factors; D013548:Sweden