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On the basis of previously reported findings that a high percentage of court-referred children suffered from serious psychopathology other than sociopathy, attention is called to some essential, though often overlooked, elements of the diagnostic evaluation of delinquents. Emphasis is on a meticulous history, including careful attention to the significances of family histories of serious psychiatric and/or neurological disorders. The importance of a detailed perinatal and medical history, with emphasis on determining a possible history of significant insult to the central nervous system, is stressed. A systematic mental status evaluation is strongly recommended. Techniques for assessing the existence of significant hallucinatory and delusional experiences in children are suggested. The uses of psychological and neurological evaluations to augment the psychiatric are discussed. The poor social situation from which many delinquents come as well as the obvious intrafamilial psychodynamic factors influencing delinquent behavior are recognized as frequent impediments to the search for less obvious psychotic and/or organic vulnerabilities in the juvenile offender. Case histories of several children who had previously been dismissed as merely sociopathic, illustrate the thesis of the paper.

This report explores some associations among juvenile-delinquency, subsequent criminality, and subsequent psychiatric treatment. A sample of 255 males known to the juvenile court 25 years prior to the study is examined in terms of subsequent documented psychiatric treatment and/or criminal activity. Of the 255 former delinquents, 6% were known later to both criminal justice and psychiatric systems, 6% to psychiatric systems only, 28% to the criminal justice system only, and 60% to neither. Delinquents with later psychiatric histories were twice as likely to be known to the criminal justice system than were those without psychiatric histories. Those with adult psychiatric histories were also significantly younger at the time of their first delinquent offense and committed more juvenile offenses than the nonpsychiatric group. Only 2 of the 16 individuals later known to both systems were diagnosed sociopathic. The findings are discussed.

Five problem areas in the management of the unwed pregnant minor are discussed in the context of a case presentation. These areas include the rights of the individual minor herself, the rights of her infant, the rights of her parents or parent, the rights of society, and the rights of the unborn fetus. The importance of helping the minor and her parents arrive at a resolution for themselves is evident. In the event of incompetence, a recommendation is made for the formation of an advisory group. Guidelines for the tasks confronting this advisory group are offered.

This paper describes the characteristics of girls referred to a consulting psychiatrist by the Young Mothers Clinic, part of a comprehensive service program for school-age mothers in New Haven, Conn. This program provided obstetrical, educational, and social services to the study group, which consisted of 180 patients who entered the clinic over a two year period. All of the study group were under 18 years of age and unwed when they registered for the clinic, and most were nonwhite. — Twenty-five of the 180 girls were referred to the psychiatrist. Common reasons for referral included lack of attention, delinquency, learning difficulties at school, withdrawn behavior, depression, suicidal threats, and chaotic home situations. Those referred were found frequently to have 1. a history of contact with juvenile court and/or 2. low scores on the Wechsler intelligence scales and poor scores on the Bender Gestalt test. — White girls were more likely to be referred than were nonwhite girls. Girls 15 years of age or under were more likely to be referred than older girls. These two groups (i.e. the younger group and the white group) tended to come from extremely disorganized homes. — Clinically, the psychiatrist was impressed by the repeated history of maternal deprivation among the referred patients. She hypothesized that the girls' unfulfilled yearning for closeness with their mothers may have driven them toward early physical relationships with boys, resulting in the pregnancies. Therapeutic recommendations were difficult to implement primarily because the girls, for various reasons, did not follow through with referrals to other sources of care.