34<5 READINGS IN BIOLOGICAL SCIENCE 



to head injuries are rather infrequent; although mental disorders sometimes 

 ensue following head injury, they are generally not sufficiently disturbing 

 to call for commitment to mental hospitals. 



There are some types of mental disorder which have no uniform and 

 clearly demonstrable organic bases. They are, perhaps, constitutional in 

 predisposition and environmental as far as precipitating factors are con- 

 cerned. With the group of depressions, which account for about 12 per 

 cent, of first admissions, some progress has been made with "shock therapy" 

 in recent months. These depressions are rather inclined to spontaneous re- 

 covery and usually do not call for a long hospital residence, except for 

 that relatively small group which occurs during the involutional period 

 and in which the duration is somewhat longer and the prognosis somewhat 

 less favorable. Another large group and very important one is that of 

 dementia praecox, or, as it is frequently termed, schizophrenia. On account 

 of the relatively early age at which this tends to develop and the rather 

 long course which it is inclined to run, nearly one half of the population 

 of any mental hospital is found to be suffering from this disorder, although 

 the first admission rate is only about 20 per cent. Much research work is 

 being carried on in the field of schizophrenia, and a little progress has been 

 made recently through the so-called "shock" treatment. Many baffling 

 problems are still presented, however, and the future is not entirely clear. 

 It is felt by those experienced in this field that much depends upon preven- 

 tive activities, which will be touched upon later. 



The question is often asked whether mental disorder is increasing. The 

 warning should be given that the only reliable statistics are those of hos- 

 pitaHzed mental patients. We have very inadequate means of knowing how 

 many cases of mental disorder there are in the community. Consequently, 

 if a state provides inadequate facilities and makes it extremely difficult to 

 enter a hospital, it may boast of a low mental hospital rate. If, on the other, 

 hand, it is progressive, as New York State is, providing ample facilities, 

 a large proportion of those in need of care will receive it. The discrepancy 

 among the several states in the rate (per 100,000 general population) of 

 the patients hospitalized is enormous, the figures for New York and Ala- 

 bama being respectively 464.5 and 163.5. ^^ ^^^Y t>e said very briefly that 

 there appears to be a slight general rise in the admissions to mental hospitals, 

 and a slight increase, rather steady, in the population of these hospitals. It 

 is questionable whether at the present time, at least, the prospect is alarm- 

 ing. The figures which have been given for the trend in the senile and 

 arteriosclerotic groups, however, certainly seem to indicate heavier future 

 demands for mental hospital facilities. 



Much used to be said about the influence of heredity in mental disorder. 

 That there is such a thing as heredit)^ can not be denied, but it is not looked 

 upon to-day as one of those inescapable things to which one may as well 

 surrender without a struggle. The growth of the mental hygiene movement 



