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Am J Psychiatry 1958;114:961-969.
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The Department of Psychiatry and Neurology, Washington Univ. School of Med., St. Louis, Mo.

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1. A preliminary report of the first 150 interviewed subjects in a long-term (30-year) follow-up study has been presented. This report emphasizes the adult psychiatric diagnoses and their relation to childhood problems.2. Patients referred to a child guidance clinic 30 years ago were found to have a high rate of psychiatric disease as adults as compared with a matched group of normal controls. They differed little from the normal controls in their rate of neurotic reactions but presented many cases of sociopathic personalities, psychotic reactions, and alcoholism.3. The patients who contributed primarily to the diagnosis of sociopathic personality were those who had been juvenile delinquents as children. Many of those who were psychotic as adults had a history of anti-social behavior in childhood without court hearings. Patients who were psychiatrically well as adults came mainly from the group with neurotic problems as children. The relations between the specific presenting problem and the adult psychiatric disease show that the well group was characterized by problems such as fighting, sex problems, tantrums, and the classic neurotic traits of childhood.4. While children with neurotic problems came from families of better socio-economic background than children with anti-social problems and delinquency, class background was not found to account for the greater proportion of psychiatrically well as adults among the subjects who had had neurotic problems in childhood.5. While patients had a higher rate of broken homes than controls, broken homes were not found to be related to the continuance of psychiatric problems into adult life.6. Although the rate of psychiatric disease is very high in the patient group, very few of them have sought any psychiatric help.

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