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Psychiatric Illness in Adolescence: Presentation and Prognosis

St. Ebba's Hospital, Epsom

ABSTRACT

This paper reviews 362 patients admitted to the adolescent unit at St. Ebba's Hospital between 1949 and 1954 and followed up for over two years.

Behaviour disorders accounted for half the admissions. The prognosis was good in comparison with the adult psychopath, 38 per cent. making a complete remission. The most valuable guide to prognosis was the symptomatology. Stealing as an isolated symptom had an excellent outcome whilst a combination of stealing, violence and truancy in the same individual was of poor import. Heredity and background showed little relationship to prognosis.

A quarter of admissions suffered from schizophrenia with symptoms similar to those in adult life. The prognosis was poorer than in adults, only a fifth recovering compared with a third of adults. Heredity and background had little influence on outcome. The most significant prognostic factor was sex, twice as many females making a complete remission. Results were similar with deep insulin and psychotherapy.

A quarter of patients suffered from neuroses and affective disorders. Obsessional states and affective psychoses were rare, each forming 2 per cent. of admissions, and their prognosis was excellent.

Schizophrenia developed in a few patients originally placed in other diagnostic categories. This was most common with anxiety states (15 per cent.), less with hysteria (7 per cent.) and rare in behaviour disorders (1 per cent.). No patients with obsessional states or affective disorders developed schizophrenia at follow-up.