The changing nature of diagnosis in an inpatient service over 20 years.

This study examined factors related to mental illness in children and adolescents. A survey of all 362 files of child and adolescent patients discharged from a single residential treatment facility in 1961-1962, 1971-1972, and 1978 revealed several major diagnostic trends. The proportion of cases diagnosed as schizophrenic decreased by one-third, those diagnosed as neurotic increased over ten-fold, and significant increases occurred in the proportion of children diagnosed as autistic, personality disorder, and behavior disorder of childhood and adolescence. There was a decrease in cases between 6 and 12 years of age and a significant increase in 13- to 18-year-olds. The relative importance of symptoms appeared to be interpreted differently at various times. Significant changes were also found In treatment length, in medications used, and in a number of factors related to the characteristics of the family.