Historical Overview

The history of child and adolescent psychiatry as a medical specialty in the United States dates back to the beginning of the twentieth century (Rothenberg 1979). Several historical events have marked the progress of the specialty, including the establishment of the first child guidance clinic in Chicago in 1909 and, in 1930, the first full-time psychiatric clinic in the department of pediatrics at the Johns Hopkins School of Medicine. An influential 1932 report on the relationship between pediatrics and psychiatry advocated for greater integration of mental health disciplines into the pediatric hospital and the development of liaison programs to help increase awareness of the psychological issues affecting physically ill children (Fritz 1993; Work 1989). In 1935, Leo Kanner published the first edition of his textbook, Child Psychiatry, and the Rockefeller Foundation funded the development of several psychosomatic medicine units in U.S. teaching hospitals. In 1953, The American Academy of Child and Adolescent Psychiatry (AACAP) was founded, followed shortly afterward by board certification in child psychiatry. Further growth of the specialty occurred following the decision of the National Institute of Mental Health to fund training grants and research during the 1970s and 1980s.

Psychosomatic medicine has more recently been recognized as a separate psychiatric subspecialty by the American Board of Medical Specialties. In the past, it has been designated by several other names, including consultation-liaison psychiatry, medical-surgical psychiatry, psychological medicine, behavioral psychology, and pediatric psychology. The field overlaps with the pediatric specialty of developmental and behavioral pediatrics. In 2001, the Academy of Psychosomatic Medicine applied to the American Board of Psychiatry and Neurology (ABPN) for recognition of the name psychosomatic medicine as a subspecialty, using the name that was introduced by Felix Deutsch in 1922 and that has been associated with the ABPN's history, national organizations, and journal publications (Deutsch 1922; Lipsitt 2001).

Training in pediatric psychosomatic medicine, which generally occurs in a pediatric consultation-liaison service, is a mandatory component of training in ABPN-accredited residency programs in child and adolescent psychiatry. Recently, investigators have developed specific diagnostic criteria for psychosomatic research to help researchers and clinicians with operational criteria for psychosomatic syndromes most commonly identified in the medical setting (Fabbri et al. 2007).

In 1967, Logan Wright introduced the term pediatric psychology. The field of pediatric psychology experienced rapid growth associated with the formation in 1968 of the Society of Pediatric Psychology, an independent section of the Division of Clinical Psychology of the American Psychological Association. In addition, a number of national and international organizations are dedicated to the specialty, including the Academy of Psychosomatic Medicine, American Psychosomatic Society, European Association for Consultation-Liaison Psychiatry and Psy-chosomatics (EACLPP), International Organization for Consultation-Liaison Psychiatry, and Society of Pediatric Psychology. The EACLPP has taken a number of initiatives to help establish consensus on the contents and organization of training in psychosomatic medicine within the European Union (Söllner and Creed 2007). The AACAP also sponsors two committees, the Committee on the Physically Ill Child and the Committee on Collaboration with Medical Professionals, that focus on clinical and research issues specifically related to pediatric psychosomatic medicine. A number of journals specialize in topics related to the field, including Psychosomatic Medicine, Psychosomatics, Journal of Psychosomatic Research, and Journal of Pediatric Psychology, and various specialized journals focus on specific disorders, such as oncology and transplant psychiatry.

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