The History of Adolescent Medicine

Abstract

This is the sixth article in our series on the history of pediatric specialties. The authors describe the interesting history of the evolution of adolescent medicine from the specialties of internal medicine, pediatrics, psychiatry, and The field of adolescent medicine is unique as a subspecialty in that the practice of providing care to teenagers has always been viewed historically as a responsibility of generalists. Scientific advances in subspecialty fields such as endocrinology, gynecology, gastroenterology, infectious disease, and sports medicine were incorporated with considerable success into the general practices of not only pediatricians but also internists and family practitioners. However, societal changes in the past century began to shape the way health professionals thought about adolescents and their families and significantly influenced the practice of providing health care to adolescents. The most notable change, however, was the shift from the traditional role of providing anticipatory guidance to parents toward a reduction of risk-taking behaviors aimed directly at the adolescent. The subspecialty of adolescent medicine thus emerged as an amalgam of researchers, clinicians, and educators, who, through a variety of settings, hoped to advance science, moderate public and social policy, improve health care, and stimulate health promotion to this special population of patients. MAJOR SCIENTIFIC ADVANCES IN ADOLESCENT MEDICINELandmark scientific advances of the past century contributed greatly to the growth of the field of adolescent medicine. Some of these advances resulted from primary efforts to directly improve the health of adolescents, whereas others were derived from advances in other fields of medicine that secondarily benefited adolescents. Although at times it is difficult to distinguish between these two contributors toward change, the compilation of these scientific advances were instrumental in promoting the field of adolescent medicine. The physical and hormonal changes that define puberty have been elucidated, as have major psychological, cognitive, and behavioral developments characterizing the transition from childhood to adulthood. Great strides have been made in the management of mental illnesses and chronic medical illness, in technological advancements in the field of gynecology, and in the development of birth control methods.

Hospital Designs for Patients of Different Ages

“…The scientific advances of medicine and the social changes of the past decades have increased our awareness of the need to protect and promote the health of adolescents, considered a specific population group, that is, with particular health characteristics and needs (Alderman et al, 2003). However, the degree of adjustment of the hospital services to the needs of adolescent patients is very limited and, as mentioned, adolescents are under-represented in the research on hospitalization and health services, to the point that, one could sometimes allude to the "invisibility" of the adolescents in them (Ullán, González Celador, & Manzanera, 2010).…”

Perspectives of Youths and Adults Improve the Care of Hospitalized Adolescents in Spain

“…The scientific advances of medicine and the social changes of the past decades have increased our awareness of the need to protect and promote the health of adolescents, considered a specific population group, that is, with particular health characteristics and needs (Alderman, Rieder, & Cohen, 2003). Hospital rules should take into account the perspective of adolescent patients (Wensing & Grol, 1998).…”

“…Life expectancy of children with severe diseases has improved significantly. The increase in the longevity of children with chronic diseases has led to an increase in the number of adolescents who suffer from such diseases and, consequently, an increase in the demand of hospital services for this sector of the population (Alderman, et al, 2003). However, adolescents represent a very small proportion of the total number of hospitalized patients, and their preferences and concepts of care differ from those of the adults (Farrant & Watson, 2004;Jedeloo, Staa, Latour, & Exel, 2009;Joffe, Radius, & Gall, 1998;Zimmer-Gembeck, Alexander, & Nystrom, 1997).…”

Características de um grupo de adolescentes com suspeita de neoplasia intra-epitelial cervical

“…Recursos tecnológicos para o controle destas doenças baseados na citologia estão disponíveis há mais de meio século e permitem diagnosticar e tratar as lesões pré-neoplásicas em todas as idades, mas ainda não há consenso quanto às reais conseqüências da abordagem de alterações citológicas detectadas na adolescência 6 . Tanto aspectos comportamentais relacionados à revolução sexual e experimentados ainda na adolescência quanto aspectos de natureza biológica atribuídos à localização da "zona de transformação" são riscos adicionais para aquisição de infecção pelo HPV e maior morbidade cervical 7 . Postulou-se que muitas mulheres adultas que apresentam lesões cervicais de alto grau foram infectadas pelo HPV durante a adolescência 8 10 .…”