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20 YEARS SINCE THE FOUNDATION OF THE ROMANIAN SOCIETY OF CHILD AND ADOLESCENT OF NEUROLOGY AND PSYCHIATRY

Autor: Constantin Lupu
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The specialty of child neuropsychiatry, transformed into child and adolescent neurology and psychiatry, was founded in Romania by Mrs. Dr. Florica Bagdazar.

By her strength and skill, the network of neuropsychiatry, and the first official, medical and clinical institutions have been established in Bucharest, Cluj, Iaşi, Jimbolia and Cernăuţi. Gradually, centers with a medico-psycho-social vision have been created in these towns with the aim of taking care of children, adolescents, young people and their families.

The specialty of child neuropsychiatry had entered in the official nomenclature when Prof. Dumitru Bagdazar and his wife, Florica Bagdazar, were ministers in the Ministry of Health. After the war, between 1946-1949, the modern vision of the Bagdazars, have meet a severe communist opposition, leading to the loss of positive steps taken in organizing our specialty, so much needed for children with neuropsychiatric diseases.

Gradually, after 1955-1960, some administrative centers appeared shyly, built after a Soviet model, and some USSM (Union Society of Medical Sciences) manifestations took place, consisting of rare communication sessions, even a short lived NPI circle. The rare, but interesting communications within the NPI circle, could be heard at the USSM Adult (or, more rarely Child) Neurology and Psychiatry Communication Sessions.

The Anticommunist revolution from December 1989 brought hope of renewal and rights, of which the community of child and adolescent neurology and psychiatry specialists has been deprived for half a century. We may call it a revolution of the youth of adolescents and of children, who manifested, fought and died for a better life. Then, in January 1990,the unusual hot weather announced an early spring, and that reminded us of our former methodological meetings according to areas, which here, in Banat, were held annually.

Usually, there were scientific communications, focusing especially on new trends and discoveries, of which some major topics repeated exposures from the “NPI Thursdays”, that used to take place at the Timisoara Clinic since 1980. These professional Thursday meetings created a pleasant atmosphere and a cohesion between us, and, in case of reports and essays, they used to attract participants from other specialties, too.

In January 1990, when I called the meeting to review the preceding year’s activity, I tried to find news to communicate to colleagues. I went to the new political leaders (FSN), to the Health Department and to USSM, but no directive concerning the health network had been received after the Revolution.

Since the call of the meeting had already been made, the representatives from Arad, Caras-Severin, Alba, Hunedoara and Timis, with guests from Sibiu, arrived to Arad. Some people from Timisoara, who participated or had lived the days of the December 1989 revolution, were convinced that changes would take place and that we could created them.

So that, on Friday 26 and Saturday 27 of January 1990, specialists from the centres subordinated to Timisoara arrived in Arad to the annual meeting of the Methodological Center, Our hosts were Ms. Dr. Judith Krisbay – chief physician to NPI Arad, and her colleagues from our network. The meeting took place at the Arad section, on Oituz street.

In those days after the revolution, our world was shy, uncertain, as if we were waiting for negative events to happen. We used to wonder if, in fact, we had really got rid of communism or there were still chances for it to come back. But we wanted to benefit from some of the freedoms that have been announced by the politicians. We wondered if reprisals or penalties were likely to follow for those who asked for changes.

In many areas is changes had been announced, especially the former leaders were changed with new ones, even younger but unknown.

Of course, the hopes of those working in healthcare were parallel to the ones of people in other areas, who also wanted change.

We wanted not only administrative or economic improvements, but also professional ones. After discussions on reports, difficulties and “shortcomings” of the preceding year presented by colleagues from Deva, Hunedoara, Petroşani, Păclişa, Arad, Lugoj, Timişoara, Reşiţa, Alba-Iulia, with numbers of consultations, recovery procedures, stimulation, speech therapy, etc., highlighting the difficulties in medical assistance: the great number of consultations and hospitalizations, the lack of equipment, overloading, lack of professional development courses (while attending the political courses was an obligation for everybody), and material, organizational and relational difficulties with the management.

During the years 1980s the usual medicines were: Bromoval, Napoton, Extraveral, Chlorpromazine, Glutarom, Mentosan, which were not always available.

The final section of the agenda was set to “discussions and proposals for 1990”. The delegates asked for a supplementation of the number of physicians, psychologists and supporting staff, of professional meetings on topics of interest. The 48 participants seemed to expect something. A vague but positive anxiety was floating in the air: a hope for at least one good piece of news to take home!

Since our specialties were classified in the USSM system as subsections or simple circles with infrequent communication sessions, I felt that it was time for me to propose to organize ourselves into a union of our own, made up of child neuropsychiatric specialists, which should be called the Romanian Society of Child and Adolescent Neurology and Psychiatry.

The proposal was supported by Dr. Urzica Dogaru (Deva), Psihologist Petre Ghui (Arad), Dr. T. Mircea (Timişoara), Dr. Şeulean (Alba-Iulia), Dr. Judith Krisbay (Arad) and others. Our meeting was enlivened, the hosts gave us sheets of paper and we began to register those who agreed to be the founding members of RSCANP.

The protocol was drafted and the lists of founders included all the 48 participants from the 6 counties present at the meeting.

A a modest but pleasant indeed festive dinner followed. People were happier and more proud of this step forward.

I was asked by the uncertain: “Do you think there will be something out of this?” while others, more optimistical, congratulated me for the inspiration and courage to put forward such an idea. I was wished success in achieving this professional aim. The news about the proposal to establish the Society of Child and Adolescent Neurology and Psychiatry appeared in the local and central media on January 30, 1990 and I thought of it as the official date of foundation of RSCANP.

Thereafter, we sent a letter to Conf. Dr. Ştefan Milea from Bucharest telling about the establishing of RSCANP, proposing him to continue the list of founding members in the capital and around the country. In order to legalize the Society legal procedures were required and a statute, too, which Prof. Dr. Viorel Ghiran in Cluj Napoca offered to write. The first scientific event of the Arad founded RSCANP was “the Intercounty Neuropsychiatry Symposium” held on 6-7 April, 1990 in Lugoj. The topics covered were as follows: Emergencies in neurology and child and adolescent psychiatry – by Dr. L. Borbil,Dr. C. Lupu and Dr. I. Marcu , followed by proposals for providing emergency assistance in child neuropsychiatry.

For the supporting health care staff the topic was “Motor and Psychotherapeutic Stimulation and Recovery”. Since then, on RSCANP organized annual conferences and congresses in different cities around the country. After opening of the country’s borders, colleagues were able to participate in dozens of congresses and meetings in Europe, America, Asia and Australia.

After founding RSCANP the year 1990 was rich in the foundation of other associations and NGOs in our field, such as the Spastic Association from Dezna established by Dr. C. Barsan, The Association for Muscle Diseases in Arad established by Antoci Family,L. Ciucur Association for Duchenne dystrophy in Timişoara, Hope Association for the Mentally Handicapped, etc.

In June 1990, I proposed to the Ministry of Sports, to establish the Romanian Federation of Sports for the Disabled (RFSD), which was founded in December 1990 and whose vice-president I was elected. In medicine, these professional societies replaced the former USSM divisions. They were followed by others societies: Orthopedics-Surgery, Pediatrics, Cardiology, Cardiovascular Surgery, etc. Timisoara witnessed the emergence of: Medical Association of Timisoara, Timisoara Psychiatric Association, “Dr. Eliza Ionescu” Neuropsychiatry Association, which subsequently affiliated to national associations and societies.

After hitting the road in 1990, RSCANP started preparations to legalize its status, a procedure that lasted until 1992, when, at the National Conference of PACLISA NPI, Prof. Dr. V. Ghiran,was elected President by the General Assembly and the legal court in Cluj entered RSCANP in the register of approved associations with MS in 1993. Here is a list of the elected presidents to date: Prof. Dr. St. Milea, Prof. Dr. T. Mircea, Dr C. Lupu, and Ms. Dr. Axinia Corches (since 2009).

Starting with 1997, at the initiative of Prof. Dr. T. Mircea, he Journal of RSCANP was published quarterly, being now in its 13th year of publication. Here is a list of conferences and congresses organized by RSCANP:

1990 – Lugoj

1991 – Sibiu

1992 – Păclişa

1993 – Timişoara

1994 – Braşov

1995 – Reşiţa

1996 – Cluj-Napoca

1997 – Săpoca-Ojasca, Buzău

1998 – Târgu-Mureş

1999 – Craiova

2000 – Miercurea-Ciuc

2001 – Bucureşti

2002 – Sibiu

2003 – Timişoara

2004 – Băile Herculane

2005 – Gura Humorului (Suceava)

2006 – Neptun (Constanţa)

2007 – Sinaia

2008 – Băile Felix (Oradea)

2009 – Timişoara

2010 – Târgu-Mureş

In its 20 years of existence, RSCANP contributed to the affirmation of our specialties and to the freedom from satellite guardianship imposed by old concepts: “NPI depends on us”. It contributed to assert the importance of our profession and to reject the alleged guardianship of others. For most adult psychiatrists and also for pediatricians, it is clear that infant, child and adolescent neuropsychiatry are independent specialties due to the many problems they have to solve, to the specifics of dealing with these ages, and to the results obtained with specific therapies known and practiced by us. In the 20 years of its existence, RSCANP proved and clarified many aspects of a much needed NGO association that should govern our specialties, which currently, in the early XXI century, are seeking to modernize in the fine areas of biochemistry, genetics, immunology, nanodetection, and even to update the terminology of mental disorders.

It is true that adult psychiatry, infant, child and adolescent psychiatry, health psychology, psychotherapies, and futurology socio-psychiatry have a common core at the initial level of specialist training and there is need for professionals to learn the principles of each of the sources mentioned above. Thus they will be able to understand that mental disorders and neurological diseases, disabilities and inadaptation begin in childhood and can be spotted at the early stages of life. Increasing number of well-trained specialists in neurology and child and adolescent psychiatry, we can make prevention and assistance a real achievement.

But, at the moment, we are still few and overworked, especially as we are needed in disadvantaged areas, too, where pathology is not dealt with CANP. So RSCANP is a young, 20 years old woman, having to face a period of maturation and wisdom gaining which usually takes 40 to 50 years. If it arrives in good hands, the future generations will benefit.

from its experience. During the 20 years of its existence there were also problems in RSCANP’s life.

The first of these problems was a lack of interest on the part of certain colleagues for the life our group of practitioners . Some of them were not prepared and informed, others did not understand the value and strength of a well defined professional NGO, able to organize our activities and to represent us in dealing with the Ministry of Health and other official bodies. This is also due to an omission on the part of teachers who prepare the specialists and who do not present the RSCANP to the young residents. There are academics who do not discuss the role and the advantages of a National Professional Society. The second aspect which needs to be tackled concerns the training of medical psychologists.

Unfortunately a new special title appeared, that of “clinician psychologist”, which was a hope for child and adolescent psychiatric and psychotherapy ser-vices. But these experts have no clinical training, they do not know why they should be trained in a psychiatric clinic and lack information on psychopathological aspects.

We lack the medico-psychological specialty of mental health and thus we witness the unfortunate situation where this discipline is practiced by pseudospecialists. These issues, and also some administrative aspects produce a dilution of the “Psy” – group which should be the main pillar of mental health as well as of children, adolescents and adults with mental and neurological disorders and diseases.

In the 20 years of RSCANP’s existence, we have created a position, a reputation among other specialties, and, at the same time, a professional independence.

By means of the RSCANP we were able to meet, to hear and to know each other. In the 20 years of existence we became a family of known and respected experts.

I must stress that all our peers from the Pediatric Neurology and Psychiatry Network, are good, modest and hard working professionals, who are also able to take over and solve medico-psychosocial complex cases.

The majority of doctors, nurses, psychologists, sociologists, recovery specialists are dedicated and keen to help examine children, adolescents and families and establish comprehensive and useful diagnoses of our patients.

We all know that we have many patients and there are many issues waiting to be solved during a consultation or hospitalization.

Despite these issues, we love our profession and, in majority, we benefit from the offers of the RSCANP. Now we can say that our young but experienced and useful Romanian Society of Child and Adolescent Neurology and Psychiatry deserves our full attention and respect, so we may wish it “A Happy Birthday”.