Comment

The current issue of “Postępy Nauk Medycznych” (“Progress in Medicine”; PNM) is devoted to problems related to developmental disabilities and evidence-based approaches to their treatment. Gathered papers have been written by representatives of separate disciplines – medicine and psychology – and are presented by us in order to convey interdisciplinary knowledge to family doctors and doctors practicing within primary health care. Reporting medical and psychological information was our goal, because in case of developmental disabilities, recommended treatment should be comprehensive, and thus provided by a variety of professionals. It is very important that there is a transfer of knowledge among those professional as it will likely result in faster and more appropriate recommendations that are given to parents by family doctors and primary health care providers. This issue on PNM is divided into three parts: review papers, original papers and clinical corner.

In the introductory article, prof. Irena Namysłowska writes that in Poland about 10% of children and adolescents suffer from psychiatric disorders. Taking into consideration that in our country there is around 7,5 million individuals from this age group, 750 000 young people need help. We cannot forget about their families, who often also need support. Thus, mental health of children and adolescents is an important social issue exacerbated by the fact that the majority of patients do not have access to help. What are the aims of mental health care system for children and adolescents? Prof. Namysłowska writes that they are as follows: 1) supporting families, teachers, social services, pediatricians, general practitioners and the care system of mother and newborn child, as well as other social agendas in the process of rising the children, 2) developing systems of early interventions, 3) delivering effective health care, and 4) providing services that are accessible to all children in order to minimize their suffering, reduce disability and help to promote their developmental potential. The most needed are community services such as outpatient clinics, day departments, crisis interventions centers. Unfortunately, there are several obstacles to optimal functioning of health care system in Poland. One of the solutions can be offering prophylactic programs as well as effective and generally available therapy.

We present to the readers of PNM six review papers. The first one is written by an American psychologist – prof. Joseph Wyatt. This paper is devoted to a phenomenon that is common in the United States, namely overreliance on the biological model in trying to explain causes of many psychological disorders. Wyatt calls this phenomenon “medicalization”. The roots of contemporary medicalization in the U.S. are traced to two primary factors – psychiatry’s efforts to re-gain lost status, and the pharmaceutical industry’s profit motives. Given that both psychiatry and the drug industry are global enterprises, medicalization threatens to escape the boundaries of the U.S. and spread to other nations. We realize that some of the theses set by prof. Wyatt are controversial, but we have decided to present his paper in order to point the attention of the readers to potential negative results of medicalization and offer some recommendations regarding therapeutic interventions.

Malicki, Dudek-Głąbicka and Ostaszewski also write about the medical model. The article focuses on the role of general practitioners and pediatricians in prevention and treatment of children’s mental health problems. The authors emphasize the role of communication between clinicians and parents of child patients, because practitioners’ attitude to and understanding of the nature of treated problems is thought to have a significant impact on children, their parents and other caregivers, and can be crucial for treatment outcomes. Malicki et al. describe a functional-contextualistic approach to mental health which can be seen as an alternative to the medical model. Functional-contextualistic approach situates psychological problems within the context of personal history and current life circumstances of an individual. Presented symptoms are seen as behaviors which have developed in the course of life as an apparently unsuccessful way of coping with life problems. The paper presents fundamentals of functional-contextualism and contains a discussion of their implications for understanding of health problems. The article concludes with advice regarding practical applications of functional-contextualistic philosophy of health to the relationship between clinicians and parents.

The next four articles describe the foundations of behavioral approach and the effectiveness of behavioral therapy for several childhood problems. Presti, Cau and Moderato write from the perspective of behavior analysis about changing eating habits of children. The authors report that a number of feeding and eating problems may arise early in a child’s life and are defined by his/her inability or refusal to eat or drink a sufficient quantity or variety of food to maintain proper nutrition. Problematic feeding is asc

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