Report of the Departmental Committee on Sterilisation.

  • Great Britain. Board of Control. Committee on Sterilisation.
Date:
1934
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Report of the Departmental Committee on Sterilisation. Source: Wellcome Collection.

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    23 appreciated, and there is no doubt that these clinical difíerences are also associated with aetiological differences. It follows that the only satisfactory method of investigating the causation of the graver forms of mental disorder would be to enquire separately into the factors operating in each clinical group. This, however, presupposes a general agreement as to what these groups are, and, unfortunately, no such agreement exists. The classification hitherto in use in England is now under revision. It presents considerable differences from that in use in central Europe, and both of them differ from that used in America. It is clear that until agreement can be reached on this fundamental point of classification, full use cannot be made of foreign statistics, whilst a comparison of these with English figures may tend to give misleading results. (37) Lastly, in spite of various investigations which have been made in recent years, the available data are still insufficient to enable a final answer to be given to many questions relating to causation. There is great need in this country for systematic and intensive enquiry into all the hereditary and environmental factors which may operate in the production, not of mental disorder in the mass, but of each distinctive clinical type ; and equally great need for checking the results so obtained against a control group of the mentally sound. While we cannot ignore these difficulties and gaps in our knowledge, we must not be understood as implying that no reliable information exists. This is far from the truth. There is a con¬ siderable body of evidence, mostly derived from foreign sources, relating to certain particular types of mental disorder. We have also received some evidence relating to the causation of certifiable mental disorders in general. Although these data leave many questions regarding causation unanswered, we are of the opinion that they are sufficient to justify us in arriving at some general conclusions, which are stated at the end of this chapter. (b) Causation of Particular Types of Mental Disorder (38) With regard to the causation of particular types of mental disorder, we are indebted to Dr. Mapother and Dr. A. J. Lewis for the following summary :— Manic-depressive psychosis : more generally, the affective types of reaction. If one limits investigation to the recurrent, indubitable cases of mania and depression, whether alternating or not, the predominant importance of the inherited factor is striking [Cf. Jolly, Medow, Jelgersma). This is constantly confirmed in clinical practice. In a large number of cases the part of the environment in leading to the manifestation of the predisposition is subordinate and even insignificant. This is not to deny that even severe recurrent attacks may be pre¬ cipitated by environmental disturbances. When, however, the