HAMILTON:(: VERY little evidence is available as to the prevalence of psychological disturbance in the child population of Britain. Estimates based upon children in psychiatric treatment are clearly quite unreliable in this field, as recognition of problems by parent and school is uncertain and referral rates are affected by public and medical attitudes and by the facilities available. The most valuable recent figures are those given by Douglas and Mulligan (1961) and by Brandon (1960). The former report upon a representative national sample of children, assessing disturbance from material gathered by health visitors and school teachers; their findings emphasize how small a proportion of children showing evidence of psychiatric disturbance are under psychiatric care. Brandon, in a study of a sample of families in the Newcastle 1000 Families Survey, found evidence of behaviour disturbance in one child in five by the age of 11.The aim of the present paper is to describe the prevalence and patterns of emotional disorder in a sample of children unselected on psychiatric grounds. The sample we arc reporting is smaller and less representative than those studied by the above authors, but unlike these studies, ours has been designed from the outset to collect social and psychiatric data. It was our aim to measure prevalence rates in this sample by a method which was independent of consultation habits, yet which employed clinically familiar concepts and terms. In this way the relationship between "illness" and consultation could be examined, and the patterns of disturbance found in this p.sychiatrically unselected population could be compared with the patterns encountered in children under psyctiiatric care.
SUBJECTSThe children, 79 boys and 80 girls, were selected by virtue of their age (born 1949 to 1955) and by the fact that they, and at least one of their parents, were registered on the National Health Service list of one of the authors (A.R.). All families meeting these criteria were included, except those known to be in Social Class 1 and 2 and nine families where adequate co-operation was not obtained. Families with older children were visited first, and the survey took three years; the children's ages at the time of interview ranged from 5 to 12 years, but most were over 6 years (Table 1), The background, social class (predominantly 3 and 4), income level, neuroticism, and marital patterns of the parents of these children have been in earlier papers (Ryle and Hamilton, 1962;Hamilton et al., 1962; Pond et al,, 1963). Caution is essential in generalizing from any circumscribed sample but there seems no reason to believe that this sample was weighted with psychiatrically disturbed families. In theory one might predict that a psychiatrically orientated general practitioner might attract or retain psychiatrically ill patients; in practice, however, the available objective criteria do not suggest that this has influenced the composition of this sample. The parents* scores on the Cornell Medical Index (Brodman et al.,...