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REMARKS UPON INSANITY AND EPILEPSY IN REGARD TO THE DURATION OF LIFE
Robert Jones
Am J Psychiatry 1905;61:467-482.
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London County Asylum, Claybury

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Abstract

(I) Insanity per se is inimical to life. It is a deterioration mental and physical. It causes more deaths in every quinquennium among the certified insane in asylums than in corresponding periods among the general population. Cases least affected are those holding fixed ideas, sometimes called paranoiacs or persons suffering from delusional insanity as are also those in whom an acute attack of insanity has left moderate but chronic weak-mind-edness. Congenital weak-mindedness diminishes the expectation of life.(2) The most powerful and the most frequent antecedent of insanity and of epilepsy is either ancestral insanity or epilepsy.(3) All medical forms of inquiry used in insurance offices should ask whether there is a history of ancestral insanity (parents and grandparents) and collaterals (uncles and aunts).(4) That a suicidal tendency is eminently heritable—often appearing at the same age in the offspring as in the ancestor.(5) That suicides in asylums occur less frequently by one-half than in the general population during the period of greatest liability.(6) That phthisis and insanity are strong converging factors towards insanity.(7) That epilepsy shortens life—more so by an average of ten years—than insanity.(8) That antecedent syphilis in many assurable cases cannot be definitely ascertained either by admission of the fact or by its sequelæ and that general paralysis occurs not more often than in about I% of all cases which have contracted syphilis.

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