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Spitz, R.A. (1945). Hospitalism—An Inquiry Into the Genesis of Psychiatric Conditions in Early Childhood. Psychoanal. St. Child, 1:53-74.

(1945). Psychoanalytic Study of the Child, 1:53-74

Hospitalism—An Inquiry Into the Genesis of Psychiatric Conditions in Early Childhood

René A. Spitz, M.D.

En la Casa de Ninos Expositos el nino se va poniendo triste y muchos de ellos mueren de tristeza.
(1760, from the diary of a Spanish bishop.)

I. The Problem

The term hospitalism designates a vitiated condition of the body due to long confinement in a hospital, or the morbid condition of the atmosphere of a hospital. The term has been increasingly preempted to specify the evil effect of institutional care on infants, placed in institutions from an early age, particularly from the psychiatric point of view. This study is especially concerned with the effect of continuous institutional care of infants under one year of age, for reasons other than sickness. The model of such institutions is the foundling home.

Medical men and administrators have long been aware of the shortcomings of such charitable institutions. At the beginning of our century one of the great foundling homes in Germany had a mortality rate of 71.5% in infants in the first year of life (1). In 1915 Chapin (2) enumerated ten asylums in the larger cities of the United States, mainly on the Eastern seaboard, in which the death rates of infants admitted during their first year of life varied from 31.7% to 75% by the end of their second year.

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