[ENCOPRESIS IN A PSYCHIATRIC CONSULTATION]

A series of ten cases of encopresis, seen in psychiatric consultation over a period of two years, is reviewed from dynamic and technical aspects. These children were found to react by regression to a traumatic separation from their mothers, over a background of maternal deprivation. A consultation approach, rather than the usual intensive psychotherapy of child and parents, was used in most of these cases, for lack of therapeutic facilities and location of family. The results have been evaluated and were found to be surprisingly better than expected. It is suggested that such an approach (psychiatric interview, social history, and interpretation to the family of specific recommendations) should be used more often before psychotherapy is attempted, thus trying to use better the emotional resources of the family. Some organic factors of this condition are discussed, as well as the role of the paediatrician in the prevention of the illness at critical stages of the child's life: namely, toilet training and birth of a sibling. The timing of the hospitalization of the child is important, and the author suggests it should not occur before the age of four. Close collaboration of the paediatrician and the child psychiatrist is most essential in such cases.