Richard J Shaw Mb Bs David R DeMaso MD

The inspiration to create the Textbook of Pediatric Psychosomatic Medicine evolved from our experience with its predecessor volume, the Clinical Manual of Pediatric Psychosomatic Medicine (Shaw and DeMaso 2006), published by American Psychiatric Publishing. The Clinical Manual was a relatively easy book to create, given the notable absence of teaching guides aimed at trainees and clinicians working in the field of pediatric psychosomatic medicine. Much of the material was drawn from our accumulated teaching, clinical, and research experience in our respective institutions. Our goal was to create a book that was of immediate practical use, with chapters dedicated to each of the most common mental health consultation questions in the pediat-ric setting.

The response to the Clinical Manual has been overwhelmingly positive. It has become one of the standard training texts in pediatric psychosomatic medicine in institutions across the United States. It has been used as a basic introductory text for medical students and psychology interns and has served experienced mental health clinicians in the development of new clinical services. The book also has had enthusiastic responses internationally, from countries in Europe, Asia, and Australia: It has been translated into and published in Chinese, and an edition in Spanish is planned.

In formulating our plans for this textbook, we were mindful of several adult texts, most notably the American Psychiatric Publishing Textbook of Psychosomatic Medicine, edited by James Levenson (2005), which served as a template for this book. We also drew inspiration from the Textbook of Consultation-Liaison Psychiatry, edited by James Rundell and Michael Wise (1996), and Psychosomatic Medicine, edited by Michael Blumenfield and James Strain (2006). These individuals have all been pioneers in the adult field and have helped consolidate the specialty of psychosomatic medicine. Our sources in pediatric practice were more limited, but two publications, Child and Adolescent Mental Health Consultation in Hospitals, Schools, and Courts, by Gregory Fritz and colleagues (1993), and the Handbook of Pediatric Psychology, edited by Michael Roberts (2003), deserve special mention.

In the current volume, our goal has been to help articulate the current evidence base for pediatric psychosomatic medicine. Although the relatively recent establishment of the certification process of psychosomatic medicine by the American Board of Psychiatry and Neurology has drawn increased attention to psychosomatic medicine, we felt that it was important that pediatric issues receive their own unique and separate attention. This opinion has been further strengthened by our experience in developing the textbook's first chapter, which reviews the international practice of pediatric psychosomatic medicine. The widely varied allocation of resources to address the psychological issues of physically ill children across countries and continents emphasized for us the fact that support for our specialty cannot be taken for granted. We believe it is imperative not only to continue but also to intensify efforts to establish the clinical and economic benefits of mental health intervention in the medical setting.

In developing an outline for this textbook, we decided to focus primarily on evidence-based work in the field. This objective is in contrast to the more practical applications that were emphasized in the Clinical Manual. In addition, due to constraints on length, we selected the most common clinical areas to cover in depth rather than conducting a more superficial review of the entire field. For this reason, certain topics—including spinal cord injury and several disorders in the specialties of hematology, rheumatology, and dermatology—are notably absent. We made a conscious decision to omit topics that are classically associated with child and adolescent psychiatry, such as enuresis, encopresis, and atten-tion-deficit/hyperactivity disorder. Although patients with these disorders frequently present in the medical setting, we believe that numerous outstanding texts are available on the management of these disorders. For similar reasons, mental retardation, autism, and developmental disorders are not specifically addressed.

This textbook is organized into four main parts. As in the Clinical Manual, the first four chapters provide a general introduction to the specialty of pedi-

atric psychosomatic medicine, a discussion of the areas of adaptation and coping, an exploration of assessment, and an examination of legal and forensic concerns. In Part 2, "Referral Questions," the authors of Chapters 5-13 cover the common psychiatric consultation requests in the inpatient and outpatient setting. Part 3, "Specialties and Subspecialties," includes Chapters 14-27 and addresses the most common pediatric subspecialties. In the final section, "Treatment," the authors of Chapters 28-31 discuss evidence-based treatments of the physically ill child.

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