Management of encopresis in early adolescence in a medical-psychiatric unit

The aim of this work is to present the role of a medical-psychiatric unit i n the treatment of chronic resistant encopresis in adolescence as an effect ive alternative to the standard approach. Four case reports are presented. The integrative program is based on full patient cooperation and involves s eparating the patient from the family environment and the use of medical in tervention combined with modified behavioral therapy and parental education and guidance. The patient is given full responsibility for the cure. The m edian full hospital stay for our patients tons 2 weeks, and outcome in all cases was complete remission. This experience suggests that chronic resista nt encopresis in adolescents requires a different approach from the standar d because of the patient's developmental stage and the often hostile family dynamics. A medical-psychiatric setting provides an excellent management m ilieu and can lead to a dramatic improvement in this chronic disabling cond ition. (C) 1999 Elsevier Science Inc.