The reactions of hospitalized children to illness.

590 PEDIATRICS September 1958 O NE of the main interests of the Child Psychiatry Unit of the Massachusetts General Hospital from its beginning has been the study of emotions in the sick child and the prevention or treatment of emotional disturbances associated with illness. When the child is hospitalized his fears, anticipations, and concepts of his medical illness are important not only as psychologic concomitants but also as they may affect and prolong his illness. Pediatric and psychiatric studies indicate that illness and/or hospitalization may lead to, or precipitate, neurotic disturbances in children.1 Specific reports point to the potential disturbing impact of separation,’7 particularly in children under 5 years of age, of operations,8” of immobilization,’4’7 and of various chronic illnesses.’8’4 Often parents date the onset of an emotional disturbance such as tics, enuresis, phobias, and behavior problems to an illness, or to hospitalization. Such experiences in childhood may have an effect that lasts into adult life in the form of attitudes toward physicians, illness, and body 26 One frequently observes in parents that their childhood experience regarding illness may influence the way in which they affect their child’s reaction to hospitalization or operation. However, pediatric experience shows that most children adapt to the painful and frightening experiences of hospitalization. Also improvement in health is usually followed by a spurt in development as the emotional energy previously bound up in the illness is released, and there is a resumption of interest in activities and people. There are fewer studies reported which clarify the constructive forces within the child, his family, and the hospital environ728 The effectiveness of a hospital program which makes use of psychologic principles, however, has been demonstrated.29, 30