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Early child psychiatry

Published online by Cambridge University Press:  02 January 2018

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Disturbed and disobedient children can cause much distress to their parents, sometimes precipitating maternal depression. In the Book of Proverbs the word ‘fool’ denotes a character corresponding to the modern concept of personality disorder (mainly antisocial). Parental grief or depression associated with having a fool as a child is described in three separate entries:

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Copyright © Royal College of Psychiatrists, 2010 

Disturbed and disobedient children can cause much distress to their parents, sometimes precipitating maternal depression. In the Book of Proverbs the word ‘fool’ denotes a character corresponding to the modern concept of personality disorder (mainly antisocial). Parental grief or depression associated with having a fool as a child is described in three separate entries:

  1. 10:1 ‘A wise child makes a glad father, but a foolish child is a mother's grief.’

  2. 17:21 ‘The one who begets a fool gets trouble; the parent of the fool has no joy.’

  3. 17:25 ‘Foolish children are a grief to their father, and bitterness to her who bore them.’

In the recent child psychiatry literature numerous studies replicate this association between maternal depression and having children with conduct disorder, thus confirming the views of the scribes of the Book of Proverbs.

But what was the management of the more seriously disturbed and delinquent adolescents, a group that still poses a major challenge to services today? Here the parents liaised with the local ‘social services’ (the elders) and the solution they came up with is described in Deuteronomy 21:18–21.

21:18 ‘If someone has a stubborn and rebellious son who will not obey his father and mother, who does not heed them when they discipline him, 19 Then his father and mother shall take hold of him and bring him out to the elders of his town at the gate of that place. 20 They shall say to the elders of his town “This son of ours is stubborn and rebellious. He will not obey us. He is a glutton and a drunkard.” 21 Then all the men of the town shall stone him to death. So you shall purge the evil from your midst; and all Israel will be afraid.’

In the earlier patriarchal period of ancient Israel and also in ancient Rome, parents had the absolute right to execute their children. However, under this deuteronomic ruling an execution could only occur following a trial and on the authority of the elders; the killing was conducted by all the men of the town, but not the parents. It has been suggested that this option was rarely, if ever, applied and the law was used to strike fear and deterrence into the minds of the defiant youngsters. Curiously, the punishment for the insubordinate son in ancient Mesopotamia as recorded in the much older Code of Hammurabi (circa 1800 bce) was rather less severe, involving cutting off the delinquent's hands.

Society still has no answer for the rebellious, drunken, violent adolescent. However, secure adolescent provision and prison for the most dangerous individuals is a clinically useful advance over the biblical solution.

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