An Investigation of a Group of Patients who have Attended both the Child and Adult Departments of the same Psychiatric Hospital

Abstract

A group of 75 patients who have attended both the child and adult departments of the same psychiatric hospital have been studied from the point of view of the relationship of childhood to adult psychiatric illness. On the basis of groupings of childhood symptoms, 64 of the patients were allocated to three categories of childhood disturbance—"delinquent", "conduct disorder", and "neurotic." The 11 children who were excluded from this classification were considered individually. Adult diagnosis was made on the basis of data abstracted from hospital case notes and was multiple in a proportion (26 per cent.) of patients. Significant associations were found between delinquency in childhood and antisocial personality in adult life and between neurotic disorder in childhood and adult life. The childhood conduct disorder group as originally selected differed from the other two categories in having a lower incidence of antisocial personality than the delinquent and a lower incidence of neurotic disorder than the neurotic group. The childhood categories were rearranged by separating off the delinquent children with a history of court appearance from those without. The latter were then combined with the conduct disorder group to form a new "behaviour disorder" group which appeared to be associated with the diagnosis of "inadequate personality" in adult life. This resulted in the three childhood categories of "delinquent", "behaviour disorder" and "neurotic" being broadly associated in adult life with "antisocial personality", "inadequate personality" and "neurotic disorder" respectively. Associations between childhood and adult symptoms and diagnosis have also been examined and an interesting observation which would need to be confirmed on larger numbers is an apparent relationship between adult homosexuality and the combination of neurotic symptoms and temper in childhood. The results of the present study are compared with those of the follow-up studies of O'Neal and Robins in St. Louis. It is hoped in the future to add to the series and to relate the categories of disorder to various social and other data.