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Research on communication skills in psychotic patients demonstrates that in dialogues schizophrenics neglect the needs of the listener. There are only few linguistic studies which investigate the speech of schizophrenic children and adolescents. The verbal and non-verbal communication of schizophrenic, neurotic, and healthy adolescents during a problem solving situation was transcribed and compared by a content analysis. The transcripts were screened for dialogue control and communication disturbance of verbal/non-verbal activities of the speaker and listener: Dialogue control was defined by the variables signals of the speaker or signals of hearer and eye or body contact of the test person to the experimenter. Communication disturbance was defined as the amount of incomprehensible articulation and selections. Neurotic test persons produce the highest signals of speaker rate. In dialogues with neurotic and schizophrenic test persons the experimenter uses more signals of hearer than in dialogues with healthy test persons. In dialogues with neurotic test persons the experimenter shows more signals of the speaker than in dialogues with healthy test persons. Schizophrenics neglect more often the statements of the experimenter than in other dialogues and vice versa. Although the experimenter was instructed to restricted verbal behavior the communication intensified in the neurotic group. The communication in the schizophrenic group was characterized by frequent communication disturbance.

In the last few years neurobiological research has made a substantial contribution to an improved understanding of the neurodevelopmental origins of schizophrenia. Studies of functional and local brain-damage have illuminated the mechanisms of action of both the classical and the atypical neuroleptics and thus have considerable implications for a rational pharmacotherapy. Taking into account modern research on bonding, it is possible to elaborate a somato-psychosomatic model for the development of schizophrenia in childhood. The present review discusses the implications of this model for the treatment of children and adolescents with schizophrenia.

Since its first definition 100 years ago, the term conversion underwent many changes, a fact that is proved by various re-evaluations with respect to classification (DSM-IV, ICD-10). In the context of a psychodynamically-oriented diagnostic there are--in addition to that--actual attempts to reach a valid operationalization of the conversion concept. From a psychodynamic point of view a differentiation of traditional concepts has been made. Results of examinations of 45 children and adolescents (average age: 14 years, range: 8-18 years) who had been treated in the Department of Child and Adolescent Psychiatry of the University of Essen for conversion symptoms, revealed a strong interaction of oedipal and pre-oedipal conflicts and that in case that there was no help from a third object during early triangulation, the child's endeavor to break out of the primordial relationship with the primary love object had been impeded and thus individuation processes were impaired or even prevented. Our results lead to the conclusion that for the young patients, who came to us with a conversion symptom, the early pre-oedipal triangulation failed and thus primary separation and dependency conflicts could not be solved adequately.

This paper discusses psychosocial influences of diabetes mellitus type 1 on children and young patients. A group of 21 patients, age 9 to 14 years with Diabetes mellitus type 1 attended a course in "Autogenic Training" for a period of 11 weeks. From the multidimensional questionnaire for children (PFK 9-14, SETZ U. RAUSCHE 1976) 15 dimensions of personality and 5 second rank factors were extracted at the beginning and at the end of training and 5 months later. Additionally HbA1-scores were assessed at the beginning and at the end at a 2 month and a 5 month-follow-up. At the beginning of the course only on one of the 15 scales a significant difference could be observed between experimental group and age related normal population. After training 5 scales and one second rank factor showed significant changes. Significant reduction was observed in: "need for aggressive forms of dominance behaviour" "feeling of submission with respects to other:", "emotional lability" and "tendency for dependence on adults". A significantly increased score was observed in the scale measuring "self confidence regarding one's own meaning, decisions and planning ability". The second rank faktor "neuroticism" was significantly reduced. Against expectations there was no reduction in HbA1 scores. At the end of training HbA1 scores even had increased significantly. But this might have been related to the high frequency of infections during this course. In subjective ratings of training evaluation most of the course members and their parents described fewer problems with attention, less test-anxiety and less aggression and nervousness. The results of this prospective pilot-study are discussed in terms of the psychodynamic influence on diabetes.

A psychoeducational approach of the nursing staff's work with parents is presented. By offering a family visit to the unit prior to admission, systematic preparation of the admission process, reflected interactions with parents during their visits, by parents' evenings and parents' weekends, the nursing team makes a distinct contribution to the families' treatments. Pros and cons are dealt with, concerning issues of professional self-image, goal planning of the team as a whole, structures of team conferences, and supervision. As to evaluation, some parameters (incidence of dismissals for reasons of discipline, withdrawal of children against medical advice, patients referred to care of public authorities after treatment) are discussed for their usefulness.

This study addresses the question whether children taken for treatment to a psychiatric hospital for children and adolescents differ from other, not noticeably disturbed children in their use of a transitional object. Parents of mentally disturbed children between six and eight years of age were interviewed about the transitional objects used by their children. The control group was made up of children of corresponding ages from an ordinary nursery school. Based on the extant literature, the concept of "transitional object" is described and defined. Twenty two research hypotheses were formed and subjected to statistical tests. As the main result concerning the research question it emerged that the children suffering from psychiatrical disturbances needed a transitional object mainly in their fourth year of life, but to some extent even in their fifth and sixth year whereas the "healthy" children in the control group without noticeable disturbances used a transitional object mainly in their first and second years. It could be shown with statistical significance that psychiatrically disturbed children had a transitional object at a later age and for a longer period of time than healthy, undisturbed children.