[5] In 1945, the psychoanalyst René Spitz published an article in which he explained how deprivation of social interactions can lead to a condition named "hospitalism" in infants.
[3] In 1897 Floyd M. Crandall published an article in Archive of Pediatrics in which he used the term to describe a condition in institutionalized infants characterized by loss of weight, susceptibility to various diseases, and ultimately death.
According to Crandall, this high mortality rate of institutionalized children under one-year-old was suspected to be caused by a lack of hygiene, food, air, exercise and personal contact.
Breastfeeding became increasingly important since it was considered to provide sufficient nutrition and to improve the infants' immune systems, which helped to reduce the mortality rate.
[3] The pediatrician Meinhard von Pfaundler criticized this approach and argued that this rational and distant care would damage the infants' physical and emotional well-being.
The so-called Viennese Baby Tests were created by Charlotte Bühler and could be used to assess the mental, social, and physical development of children.
[3] In 1945 the psychoanalyst René Spitz redefined the term hospitalism by arguing that the mortality rate of infants was still high, despite the isolation in cubicles, because the lack of maternal care impaired their development.
[3] Spitz conducted research for his hypothesis by comparing infants in a foundling hospital in Mexico and in a prison nursery in New York City with two control groups of children growing up with their families.
[3] This idea had a strong influence on other researchers, and in 1951, the British psychoanalyst John Bowlby published a report on homeless children in the US.
According to Bowlby, a child needs to have a loving and continuous relationship with the mother to avoid permanent developmental damage and hospitalism.
[11] Patients tend to have a strong predisposition to marasmus, which increases mental and physical fragility, alongside an impairment of their immune system, leading them to be at higher risk for infections and viral diseases.
Especially in children that stayed in orphanages for a long time and suffer from deprivation syndrome – the sensory withdrawal before adulthood resulting in physical and psychological damages – one can observe a reduction of activities due to a lack of motivation and suppression of feelings.
[12] Patients are also at higher risk for various mental disorders and anti-social behaviors:[11] Individuals suffering from hospitalism are also at risk for sensory perception problems:[12] Other common consequences relate to cognitive disorders, such as:[12] Long-term consequences, which is causally related to traumatic experiences, can be expressed in different ways.
[14] Therapeutic interventions should be carried out by specially trained professionals, psychotherapists, psychologists, social workers, teachers, and a network of non-professionals for people who are physically, mentally, or emotionally handicapped.