Funnel chest. Psychological and psychosomatic aspects in children, youngsters, and young adults

Background. When considering the indications for operative correction of fu nnel chest, the first question is what is medically actually necessary, and what is founded simply on 'doctors opinion', Furthermore symptoms are ofte n only indirectly correlated with the basic illness. This paper suggests a possible way of objectivating the symptoms in 56 patients with funnel chest . Methods. According to the results of our retrospective examinations the dif ferentiation between 'physical' and (merely) 'cosmetic' findings in the def inition of indications for operation of funnel chests in children, youngste rs and young adults, should be dispensed with, The symptoms of "funnel ches t" can be of varied significance, according to the degree of deformity, ran ging from cosmetic fault to a severe handicap. Definition of indication thu s depends in each case on all-inclusive plus differential plus interlocking -systemic diagnosis. In the course of this, not only somatic data, but also psychosocial characteristics can be objectivated and quantified. Results, The results of our examinations show that the handicaps of a funnel chest i nfluence all areas of life. Older children (over 11 years) display as a who le more psychological disorders. Along with specific embarassment reactions , social anxiety, feelings of stigma, Limited capacity for work, orientatio n towards failure, reduced tolerance of frustration and temptation, Limited capacity for communication and even markedly depressive reactions are obse rved. Conclusions. The underlying deformity and the psychological reactions to it make a long-term psychotherapy necessary, This may be laid out methodicall y more simply and takes less time, when a permanent correction is brought a bout at operation.