Pediatric Annals


The Psychiatric/Pediatric Interface

Stanford T Shulman, MD


Collaboration between specialists may lead to a better understanding of each speciality's characteristics.


Collaboration between specialists may lead to a better understanding of each speciality's characteristics.

As attending physician on the General Pediatric service, or when involved with Pediatric HIV patients, or while caring for outpatients in the Infectious Diseases clinic, I am often confronted with situations in which the medical decisions are fairly straight-forward but the psycho-social context provides significant challenges. I am certain that this experience is shared by the readership of this journal. Many of these circumstances prompt us to interact with our colleagues who provide pediatric and adolescent psychiatric or psychologic care.

Dr. Richard Martini of The Children's Memorial Hospital and the Feinberg School of Medicine, Northwestern University in Chicago, has guest edited this issue of Pediatric Annals that is devoted to many child and adolescent psychiatric topics. These cover the waterfront regarding the psychiatric care of children in the primary pediatric setting from maternal post-partum depression diagnosable by the pediatrician to differentiating functional from organic pain syndromes and evaluating the psychiatric aspects of child abuse.

One of the most interesting pieces in this collection of quite practical articles is that by Dr. Gregory Fritz. This insightful essay succinctly summarizes some of the intrinsic differences, personality and otherwise, between pediatricians and child psychiatrists. Of course in doing so he generalizes about each group, but I think you will find how he characterizes (even stereotypes) us pediatricians and his brethren child psychiatrists interesting. Personally, as I reflect upon both my colleagues and the generations of pediatric trainees that I have known over the past 3 decades or so, I think he has pegged us pretty accurately. Dr. Fritz, like writers before him, emphasizes the pediatrician's generally optimistic, positive view of childhood and its contrast with the child psychiatrist's general view of childhood that emphasizes struggle, conflict, and powerlessness. He also contrasts the remarkable differences in practice characteristics of pediatricians and psychiatrists, highlights the unrealistic expectations that pediatricians and child psychiatrists may have of each other, and most important makes suggestions that may promote collaboration between these two specialties.

To resonate with the theme of this issue of Pediatric Annals, I have chosen a few stamps that honor those who provided much of the foundation for psychiatry and psychology. The blue and green stamp from Mexico honors Sigmund Freud (1856-1939), whose psychoanalytic theories and methods revolutionized psychiatry. The three not-so-colorful stamps from Hungary (Magyar), Argentina, and Russia each honors Ivan Petrovich Pavlov (1849-1936), who established the principles of conditioned reflexes. The very colorful orange and green stamp from Monaco highlights the battle against drug abuse, a topic that draws together pediatricians and child psychiatrists.


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