[Anxiety and reconstructive surgery in children and adolescents].

La psychiatrie de l'enfant Pub Date : 1995-01-01
R de Carmoy
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Abstract

Study of 133 children and adolescents hospitalized and operated in child and adolescent reconstructive surgery. We will study the fantasy representations of anxiety as it is expressed by this population, as well as the psychological repercussions of surgical interventions: behavior disorders, depression, anxiety. We will show that pre-adolescents and adolescents represent the most vulnerable patients in regard to the anxiety triggered by the surgical act and that some of them experience, at the time of the operation, episodes of psychic disorganization of psychotic appearance. We will look into the impact of this mutilating surgery and the weight of severe orthopedic handicaps, and have noted that the expression of anxiety isn't always in relation to the seriousness of the handicap and/or that of the intervention. The anxiety is linked to the psychological balance of the child which is largely due to the relationship he has with his parents and the feeling of self-esteem that the child has if he is accepted as he is. The surgeon seems to us like an important element in the dynamic of the way anxiety is dealt with since the patient and his parents establish a truly transferential bond to him that is of great intensity. The number of school problems, relational and behavioral difficulties and depressive reactions noted in this population shows that reconstructive surgery is very disorganizing for the personality and acts as a psychological trauma.

儿童和青少年的焦虑和重建手术。
儿童青少年再造手术住院133例分析。我们将研究焦虑的幻想表现,因为它是由这个人群表达的,以及手术干预的心理影响:行为障碍,抑郁,焦虑。我们将表明,青春期前和青少年是最易受手术行为引发的焦虑影响的患者,他们中的一些人在手术时,会出现精神紊乱或精神病症状。我们将研究这种致残手术的影响和严重矫形障碍的重量,并注意到焦虑的表达并不总是与残疾的严重性和/或干预的严重性有关。这种焦虑与孩子的心理平衡有关,这在很大程度上是由于他与父母的关系,以及孩子在被接受时的自尊感。在我们看来,外科医生似乎是处理焦虑的动态方式中的一个重要因素,因为病人和他的父母建立了一种真正的转移关系,这种关系是非常强烈的。在这一人群中发现的学校问题、关系和行为困难以及抑郁反应的数量表明,重建手术对人格来说是非常混乱的,而且是一种心理创伤。
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