Until the last decade there was considerable confusion about the nosology of childhood psychoses. As Kanner (1958) has pointed out, certain psychodynamically orientated writers (Szurek, 1956; Beres, 1956) have eschewed the important operation of differential diagnosis. This has led to the notion of ‘equality of schizophrenias' (Darr and Worden, 1951) and thus to the idea of a single psychosis of childhood. The controversy over this approach has now waned in the face of empirical evidence from aetiological, phenomenological and follow-up studies, and many authors have stressed the importance of age of onset in their typologies or in their attempts at a more comprehensive classification (Kanner and Lesser, 1958; Mahler et al., 1949, 1952; Bender, 1947, 1959; Anthony, 1958, 1962, and Eisenberg, 1967). As this is also central to the present study it merits examination in greater detail.

SUMMARY Twenty ‐four elective mute children were studied–this proved to be a rare condition, affecting slightly more girls than boys. They were compared with 84 speech‐retarded controles and 102 normal control children. The main findings in the case of the elective mute children were as follows. 1. Evidence of immaturity of development, particularly of speech, and an excess pf speech abnormalities. 2. A higher rate of behaviour problems, and high levels of enuresis and soiling. 3. In the majority of cases, an insidious development of excessive shyness from the earliest years of life. 4. Performance LQ. covering most ranges of ability, but with a significant excess in the lower ranges. 5. A high rate of Psychiatric disturbance in the families of elective mute children. 6. And, finally, on follow‐up, elective mutism proved to be a rather intractable condition.

The beneficial effects on PTSD support the use of individual therapy. However, the small sample size and lack of a control group limit conclusions about changes attributable to treatment.

The data support the notion of a victim-to-victimiser cycle in a minority of male perpetrators but not among the female victims studied. Sexual abuse by a female in childhood may be a risk factor for a cycle of abuse in males.

A sample of children and adolescents (n = 157) attending a child psychiatry outpatient clinic with conduct or emotional disturbance were compared with community controls (n = 76) for the number and type of recent life events. A Life Events Schedule for children and adolescents was developed and used as a semi-structured interview. Four clinical groups were identified according to their predominant presenting symptoms (conduct, mild mood, severe mood, or somatic). An excess of events carrying a severe degree of negative impact was found for all four groups, compared with matched controls. Eleven classes of events were examined: there is a suggestion that two classes (martial/family, accident/illness) may be more important for conduct and mild mood disorders, and that a further class (permanent separations, termed exits) may be more important for somatic and severe mood disorders.

This paper analyses the clinical picture in 80 children referred to the Park Hospital, Oxford, or to the Newcastle department of child psychiatry, and admitted for intensive assessment of their psychosis. All were seen by two psychiatrists and nearly three quarters of them in Oxford. The diagnostic criteria, and the differentiation by age of onset into infantile psychosis (I.P.) and late onset psychosis (L.O.P.) were discussed in the previous paper (Kolvin, I).

Social and family (especially multiple family) disadvantages during childhood predispose individuals to an increased risk of major depression in adulthood.

SummaryA double-blind trial failed to demonstrate any significant short-term effects of clomipramine in doses recommended for use in general practice (in addition to the usual range of psychotherapeutic help) in the treatment of children with school refusal and neurotic disorder. Patterns of improvement were also studied for the sample as a whole irrespective of treatment. Neither age nor sex were significantly related to improvement, except on one behavioural measure where girls initially did better than boys. In addition, it was found that there was a rapid relief of depression but neurotic symptomatology tended to persist.