Journal of Mental Science (1947) 93: 201-254. doi: 10.1192/bjp.93.391.201
© 1947 The Royal College of Psychiatrists
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Psychiatric Aspects of the Post-Encephalitic Syndrome

D. S. Fairweather, M.A., M.D., M.R.C.P., D.P.M., Deputy Medical Superintendent

Stoke Park Colony

ABSTRACT

  1. A study of 275 post-encephalitics is presented, based on the cases admitted to Rampton State Institution as violent and dangerous mental defectives.
  2. Of 208 cases in which the date of onset is given, 90 occurred in the years 1923, 1924 and 1925.
  3. The largest number of admissions in any one year was in 1930, when 43 cases were admitted, but the remaining years between 1929 and 1939 showed a fairly steady admission rate of 14–19 per year. Cases are still being admitted, though in smaller numbers.
  4. Whereas the peak years for onset of encephalitis lethargica were 1923 and 1924, the peak years for certification were the five years between 1928–1932.
  5. Admissions came from a wide variety of institutions, but those from certified institutions for mental defectives comprised the largest number.
  6. Sex incidence is discussed.
  7. The effect of encephalitis on mental development is indicated by illustrative cases.
  8. Head measurements indicate that encephalitis tends to be associated with shorter head lengths and wider head breadths than those of the average general hospital population.
  9. Consideration is given to the incidence of psychotic symptoms, and particular reference to confusional states indicates the importance of the parent-child relationship.
  10. The psychopathic effects of the post-encephalitic state are considered in relation to mental grade.
  11. Neurotic symptoms following encephalitis are outlined.
  12. 30 cases are described in which trauma appears to have played some etiological part.
  13. 57 cases without gross Parkinsonism are summarized, especially from the point of view of behaviour disorders.
  14. 39 cases of Parkinsonism without definite histories of acute encephalitis are outlined.
  15. A summary of the social background of the post-encephalitic is presented.
  16. An outline of the course of the condition in the complete series, along with the terminal cause of death in 48 cases, is given.