Showing papers by "Michael Rutter published in 1967"

A Five to Fifteen Year Follow-up Study of Infantile Psychosis: II. Social and Behavioural Outcome

Abstract: The 63 children with infantile psychosis who attended the Maudsley Hospital between 7950 and 1958 were individually matched for age, sex, IQ and year of attendance with a control group of children with non-psychotic disorders of emotions or behaviour. Both groups were re-examined by the authors in 1963/64 and given individual psychiatric, neurological, social and psychological assessments. The social outcome at follow-up of the psychotic children was significantly worse than that of the control children, especially with regard to the proportion in paid employment. The developmental course of autism, speech, ritualistic and compulsive behaviour, aggression and self-injury, hyperkinesis and other behavioural characteristics of the psychotic children are described. The general course of infantile psychosis is outlined and it is noted that 10 of the 63 psychotic children developed fits in adolescence. Children who were untestable on any IQ test or had an IQ below 6o had a poor outcome. A severe disorder, and particularly a severe retardation of language development as shown by a profound lack of response to sounds and lack of useful speech at 5 years were also indicators of a less than good prognosis. The amount of schooling received by the psychotic child was related to the level of his social adjustment at adolescence. The often inadequate treatment and education provided is noted and it is suggested that there are grounds for a limited optimism that with better facilities somewhat better results might be obtained.

A Five to Fifteen Year Follow-up Study of Infantile Psychosis: I. Description of Sample

Abstract: The psychoses of infancy have long been a matter for controversy. The nature of the disorders, their aetiology, relationship to adult forms of psychosis, long-term outcome and response to treatment are still areas of disagreement among clinicians. Follow-up studies should provide information relevant to some of these problems. Unfortunately, the findings of published investigations have been contradictory. To a large extent contradictions appear to be related to differences in diagnostic criteria, but the failure of many writers to describe their cases adequately has made it difficult to assess the significance of possible differences.

Childhood asthma: a psychosomatic disorder? Some epidemiological considerations.

Abstract: Epidemiologists with an interest in bronchial asthma, have given little attention to the psychiatric aspects of this condition, particularly as it occurs in childhood. Clinical impressions, rather than the results of systematic studies, are responsible for the fact that some paediatricians and psychiatrists have come to view the personality of the asthmatic child in terms of a stereotype engendered by a particular type of mother-child relationship (Abramson, 1954). Moreover, there is a general belief that asthmatic children are neurotic and that this neurosis is manifest in their general behaviour, but in fact there is conflicting evidence on this point (Harris and Shure, 1956; Leigh and Marley, in press) and no definitive information is available. Children corres ponding to this stereotype, over-dependent on their over-protective mothers, anxious, tense, shy, afraid to show their emotions, yet at the same time intelli gent, ambitious, and perfectionist, are not un common, but the evidence for the stereotype is lacking (Dubo, McLean, Ching, Wright, Kaufman, and Sheldon, 1961). Studies carried out on total populations (Kraepelien, 1954; Eriksson-Lihr, 1955) have stopped short of the examination of psychiatric correlates, while those that have looked at the prevalence of psychological factors in established asthmatics have in general based their studies on patients attending hospitals (Neuhaus, 1958) or, more rarely, general practitioners (Leigh and Marley, in press). Such patients may well be highly selected from the point of view of personality and neurotic illness, and total population studies have something to contribute in these areas. The findings of a study of this type form the material of the present paper.