The Complexity of Psychiatric Care, from Pregnancy to Adolescence: Beyond the Endogenous-Exogenous Dichotomy

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Background

Child and adolescent psychiatry hosts a range of diverse epistemological positions regarding the origin of psychical suffering, from fully endogenous (e.g. genetic) to mostly exogenous (e.g. family trauma, etc.). The complexity of clinical situations generally precludes such epistemologies to require exclusive therapeutic strategies: psychodynamic psychotherapy can be fruitful in the context of monogenic genetic illnesses (at the family or individual level), while pharmacology can be a necessary tool in a variety of difficult relational contexts or personality issues (e.g. in adolescence). Thus nowadays, the most promising therapeutic perspectives in child and adolescent psychiatry attempt to do justice to the polyfactorial complexity of mental suffering (notably by refining their psychopathologies), by drawing on e.g. biopsychosocial or epigenetic models – even more so as prevention policies ask for longitudinal studies to help with the early detection of potential future troubles.

This Research Topic aims to give promising contributions to complexity-informed approaches to child and adolescent suffering and care. From epistemological perspectives and issues to methodological questions, nosography discussions, and therapeutic settings and models. Issues to be dealt with include:
• Ethical and epistemological issues related to holistic approaches of this complexity.
○ biopsychosocial models: pros and cons (holistic vs. does not prescribe a unified therapeutic strategy). Potential pitfalls: what do psychosomatic or functional disorders (notoriously difficult to diagnose in children) become within such models?
• which methods account for this complexity, either in research or (psycho)therapeutic practice (including diagnosis)?
• what do diagnostic labels become in such complex situations? E.g. dimensional vs. categorical approaches to symptom understanding.
• what does care become in such complex contexts (with many parameters and professionals to include)? How do we best model pluriprofessional settings? Within these settings, how should we model psychotherapeutic processes more specifically?
• how do we take complexity into account for temporal factors e.g. developmental milestones such as the transition to adolescence?

All types of manuscripts will be accepted. Topics may include:

● Epistemology of complexity applied to child and family mental suffering (including critical approaches ): biopsychosocial, plurifactorial models, novel developmental approaches, etc.
● Ethical and clinical implications of the complexity of child symptom management (diagnosis, therapeutic practices, etc.).
● Qualitative, quantitative and mixed methods in research and symptom analysis
● Complexity-tailored care: diversity of therapeutic settings and/or paradigms (plurifocal therapies, liaison psychiatry, etc.)
● Environmental factors and psychotherapeutic support
● Care in a longitudinal perspective (including prevention and early detection): non-specific clinical signs; dimensional vs. categorical approaches to assessment and diagnosis
● Emerging or developing symptoms (e.g. child school phobia or refusal; bullying; conspiracy theories in adolescence)
● Paradigm change in psychotherapy (e.g. non-violent resistance in mental healthcare units)
● Child-adult transition
● Psychotherapy of somatic illnesses
● Management and care of child somatic illness at a family level

Keywords: complexity, care, models, methods, settings

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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