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While in the US in the 1970s, Heinz Kohut's work served as a major rescue operation for a psychoanalytic profession that was in deep crisis, the reception in the German-speaking lands was, for multiple reasons, ultimately marked by far more ambivalence. No one explicated and defended Kohut more vigorously to his professional peers as well as to a younger generation of left-leaning psychoanalysts than the charismatic Swiss psychoanalyst (and coinventor of ethnopsychoanalysis) Fritz Morgenthaler. It was, furthermore, specifically in engaged grappling with Kohut's creative clinical innovations as well as his blind spots that Morgenthaler--as a close reading of their correspondence and respective writings shows--developed his own distinctive perspectives on the enduring riddle of how best to theorize the interrelationships between "the sexual" and other realms of existence. It was also in this context that Morgenthaler became the first European analyst of any nationality to articulate an eloquent rebuttal to the homophobic consensus that had become consolidated across the psychoanalytic diaspora since Freud's death.

Objectives: Growth retardation is a frequent complication of paediatric inflammatory bowel disease (IBD). Only a few studies report the final height of these patients, with controversial results. We compared adult height of patients with paediatric IBD with that of patients with adult-onset disease., Methods: Height data of 675 women 19-44 years of age and 454 men 23-44 years of age obtained at inclusion in the Swiss IBD cohort study registry were grouped according to the age at diagnosis: (a) prepubertal (men≤13, women≤11 years), (b) pubertal (men 13-22, women 11-18 years) and (c) adult (men>22, women>18 years of age), and compared with each other and with healthy controls., Results: Male patients with prepubertal onset of Crohn's disease (CD) had significantly lower final height (mean 172±6 cm, range 161-182) compared with men with pubertal (179±6 cm, 161-192) or adult (178±7 cm, 162-200) age at onset and the general population (178±7 cm, 142-204). Height z-scores standardized against heights of the normal population were significantly lower in all patients with a prepubertal diagnosis of CD (-0.8±0.9) compared with the other patient groups (-0.1±0.8, P<0.001). Prepubertal onset of CD emerged as a risk factor for reduced final height in patients with prepubertal CD. No difference for final height was found between patients with ulcerative or unclassified IBD diagnosed at prepubertal, pubertal or adult age., Conclusion: Prepubertal onset of CD is a risk for lower final height, independent of the initial disease location and the necessity for surgical interventions.

Background: Inflammatory bowel disease (IBD) starting during childhood has been assumed to impair quality of life (QoL) of affected children. As this aspect is crucial for further personality development, the health-related quality of life (HRQOL) was assessed in a Swiss nationwide cohort to obtain detailed information on the fields of impairment., Methods: Data were prospectively acquired from pediatric patients included in the Swiss IBD Cohort Study. IBD activity was evaluated by PCDAI and PUCAI. The age adapted KIDSCREEN questionnaire was evaluated for 110 children with IBD (64 with Crohn's disease 46 with ulcerative colitis). Data were analyzed with respect to established reference values of healthy controls., Results: In the KIDSCREEN index a moderate impairment was only found for physical wellbeing due to disease activity. In contrast, mental well-being and social support were even better as compared to control values. A subgroup analysis revealed that this observation was restricted to the children in the German speaking part of Switzerland, whereas there was no difference compared to controls in the French part of Switzerland. Furthermore, autonomy and school variables were significantly higher in the IBD patients as compared to controls., Conclusions: The social support for children with IBD is excellent in this cohort. Only physical well-being was impaired due to disease activity, whereas all other KIDSCREEN parameters were better as compared to controls. This indicates that effective coping and support strategies may be able to compensate the burden of disease in pediatric IBD patients., (© 2013 Elsevier B.V. All rights reserved.)

Objectives: Whether behavioural and emotional maladjustment is more prevalent in children with inflammatory bowel disease (IBD) than in healthy controls remains controversial. The aim of this study was to assess paediatric IBD patients for problems with emotional and behavioural adjustment and to examine associations with clinical and demographic variables., Methods: Data from paediatric patients with IBD enrolled in the Swiss IBD Cohort Study and the results of both the parent-rated Strengths and Difficulties Questionnaire (SDQ) and the self-reported Child Depression Inventory (CDI) were analysed. Of the 148 registered patients, 126 had at least one questionnaire completed and were included., Results: The mean age of 71 patients with Crohn's disease (44 males, 27 females) was 13.4 years, and 12.8 years for the 55 patients with ulcerative or indeterminate colitis. The mean duration of disease was 1.2 and 2.7 years, respectively. The total score of the SDQ was abnormal in 11.4% of cases compared to 10% in the normal population. Abnormal sub-scores were found in 20.2% of subjects for the domain of emotional problems and in 17.1% for problems with peers. The total CDI T score indicated a significantly lower prevalence of clinical depression in IBD patients than in normal youth. No correlation between the total SDQ scores or the CDI T scores and gender, type or duration of IBD, inflammatory markers or disease scores was found., Conclusions: The prevalence of problems with behavioural and emotional adjustment among Swiss paediatric IBD patients is low and comparable to that of the normal population.

Background: The prevalence of symptomatic CD in Switzerland is thought to be 1 in 1,000 inhabitants. As in other countries, oligo- and asymptomatic CD is being diagnosed with increasing frequency in all age groups., Aim: To assess the prevalence of asymptomatic CD in adolescents in eastern Switzerland., Method: Between September 1999 and July 2000 total serum IgA titres, anti-endomysium IgA (EMA) titres and anti-human tissue transglutaminase IgA (hTTG) titres were measured in the serum of healthy 11- to 18-year-old Swiss lower and upper secondary school students., Results: Of the 1,450 students (871 f = 60.1%, CI 95%) tested, 11 (10 f) had elevated levels of both EMA and TTG. The diagnosis of CD was confirmed in eight of these students by mucosal jejunal morphology (Marsh III); one exhibited normal histology. Two of the 11 students refused to undergo mucosal biopsy. None of the students, however, had symptoms suggestive of CD, nor were they stunted or underweight, and none of them had family members with known CD. All of the eight students with enteropathy went on a glutenfree diet and felt subjectively better than on a normal diet. Of the remaining students, 38 (2.6%) had family members with known CD. None of those with the relevant family history had elevated EMA or TTG levels., Conclusion: Asymptomatic CD is common. It occurs in 1 in 132 (0.75%) Swiss adolescents. The absence of subjectively recognisable symptoms suggestive of family history or other risk factors makes it difficult to diagnose this type of CD.

The prevalence of Helicobacter pylori infection in asymptomatic Swiss children is not known. The aim of this study was to determine the rate of Helicobacter pylori infection in preschool children of the Canton of St. Gallen, eastern Switzerland. A 13C-urea breath test was performed in 432 randomly selected 5- to 7-year-old children from February to September 1998. A total prevalence of 6.5% was found, with 3.9% for Swiss children and 19.2% for children of parents immigrated from countries or regions with a high prevalence of Helicobacter pylori infection. Children born in these countries and who immigrated later were Helicobacter pylori positive in 70%. In 20/21 brother and sister pairs, the status of Helicobacter pylori infection was concordant. The amount of living space per person and the educational level of parents were comparable for all Helicobacter pylori positive children (Swiss and immigrants). In conclusion, total prevalence of Helicobacter pylori infection in preschool children aged 5 to 7 is low in the eastern part of Switzerland, with a significantly higher rate in children of immigrant parents.