Chapter 28 - Children’s reactions and consequences of illness and hospitalization and transition of care from pediatric to adult settings

Summary

Chronically ill children are at risk for depression, anxiety, somatization, and illness falsification. Assessing psychiatric illness is often difficult because of physical symptoms which may mimic psychiatric symptoms or interfere with diagnostic measures. When working with acutely or chronically ill children and adolescents, it is essential to appreciate the variability in normal developmental trajectories and the importance of working with a child's family and its context. It is critical to support the parents' attempts to provide consistent guidance and limit setting to prevent detrimental emotional and behavioral consequences of childhood illness when the child or adolescent is hospitalized. Antidepressants are the most often used class in medically ill children and adolescents. Antipsychotics are used to treat delirium and some mood disorders. Transfer to adult care should be individualized and involves coordination and clear communication with the patient, family, and physicians.