Beth Ellen Davis, MD, MPH, and Elizabeth M. Stafford, MD, who are both Colonels in the U.S. Army, have put together a set of outstanding articles that focus on topics related to the theme Child Stress for this issue of Pediatric Annals. These insightful works help us to understand and recognize stress in childhood, depression in mothers (and fathers) of our patients, the impact of traumatic events on children, childhood coping issues related to changing caregivers, parenting at times of crisis like 9/1 1 or wartime, and recognition of pediatrie and adolescent stress. The final piece "Caring for the Pediatrician" is by the master, T. Berry Brazelton, MD, and should not be missed.
The importance of improving our abilities to detect and to treat the consequences of stress in children was highlighted by a patient I cared for a few weeks ago. This teenage girl with a chronic illness presented after weeks of having severe behavioral abnormalities, including mumbling, some hallucinations, mild disorientation, and regression. An extensive workup for organic causes was negative, and ultimately it was determined that she had been sexually abused for the past few years by an adult neighbor. Her encephalopathic-like behavior represented a posttraumatic stress disorder.
As pediatricians, we need to be aware of the effects of maternal stress upon the fetus and later upon the developing child. We also need to improve our ability to recognize the signs of maternal depression, because referral for appropriate mental health assistance can lead to a significant positive effect upon both maternal and child health.
No stress-related stamps this month, but I have chosen two psychiatry-relevant items and two other stamps unrelated to the topic of this issue. Sigmund Freud (18561939), the founder of psychoanalysis, was a pupil of the great French neurologist Jean-Martin Charcot and became Professor of Neurology in Vienna. He is portrayed in a small portrait on the purple and peach Liberian stamp that was released in 1973 to celebrate the 25th anniversary of the World Heath Organization. The white and green 2006 Austrian stamp (see page 172) honors the 150th birthday of Freud by showing (schematically) Die Couch von Denken im Liegen, which translates as, "The couch for thinking while lying down."
Marie Sklodowska Curie (18671934), who was awarded two Nobel Prizes, is relevant to the topic of this issue because she was apparently quite depressed for most of her life. Marie Curie and her husband, Pierre (1859-1906), isolated the element radium in 1898 for which they received the Nobel Prize in Physics in 1903. After Pierre's death when a horse-drawn carriage ran him over, she went on to receive a second Nobel Prize in Chemistry in 1911 for her discovery of polonium-210. This is the highly radioactive element that was involved recently in the poisoning of the Russian Alexander Litvinenko and is named after Marie Curie's native Poland. Both Marie and Pierre are shown on the blue Senegal stamp from 1938 (there are identical stamps from many French colonies), and Marie appears alone on the blue French stamp. The Curies' daughter, Irene, and her husband, Frederic Joliot, also were awarded a Nobel Prize in Chemistry in 1935 for transmitting radioactivity to non-radioactive elements.