Birth rank in schizophrenia: with a consideration of the bias due to changes in birth-rate

Studies of the relation between birth rank and schizophrenia (or any other disorder of adults) have hitherto been based on the assumption that, for a null hypothesis, cases will be randomly distributed among the birth ranks. In other words, if the distribution of cases is found to depart significantly from random (i.e. from equal numbers in each birth rank for each sibship size) then an association between birth rank and the disorder is held to have been demonstrated. However, we have recently shown, both from theoretical considerations (Price and Hare, 1969) and from the study of a large sample of psychiatric patients (Hare and Price, 1969b), that birth-rank distribution may depart very significantly from random because of bias arising from changes in the birth rate of the general population. The amount and direction of this bias will depend both on the changes in family size and on the number of families being started during the period of time when the patients (or any other population sample) and their siblings were born. The amount of bias is thus likely to be different in geographically different populations or in the same population at different periods of time.

Childhood experience and depression

The possibility of a relationship between early parental loss and mental illness, suicide, or delinquency in later life is a well-known, although by no means universally accepted, theory. In this investigation, we have attempted to compare patients with carefully matched controls and to investigate, when possible, the various categories of depression separately. Also, as we felt that a study concerned with childhood deprivation based solely on the physical absence of parents would tell us little of the daily emotional experiences of the child, we have attempted to take into account the quality of the family relationships present in childhood.

Puerperal psychoses: a long term study 1927-1961

There exists a vast literature on the puerperal psychoses. Most of it is incomplete in that rarely is any definition of the “puerperal period” made; frequently there is no attempt to differentiate between the various clinical syndromes seen when aetiology is considered, and little consideration is given to the extent of constitutional predisposition to psychiatric illness in the probands.

Manic-depressive psychosis: an alternative conceptual model

The traditional concept of manic-depressive psychosis has been either a bi-polar or a circular one, used interchangeably. The psychoanalytic school has invoked the polarity of much of human behaviour as an appropriate analogy. For example “The tragedy is succeeded by the satyr play: after the serious worship of God comes the merry fair… On the same basis the same sequence is represented by the cycle of guilt feelings and unscrupulousness, later by the sequence of guilt feelings and forgiveness…. The manic-depressive cycle is a cycle between periods of increased and decreased guilt feelings: … this cycle, in the last analysis, goes back to the biological cycle of hunger and satiety in the infant” (Fenichel, 1946, p. 409).