Delusions in children and teenagers admitted to Bethlem Royal Hospital in the 19th century.

The case notes of 1069 children and teenagers admitted to Bethlem Royal Hospital ('Bedlam') in the 19th century were analysed with particular reference to the frequency and types of delusions. Delusions were present in 700 (65%), among whom there were significantly more boys than girls. There was a statistically significant rise in the frequency of delusions from 1830 to the end of the century. Sixty-six per cent of the patients were discharged cured and, taken overall, the presence of delusions did not affect the prognosis: specifically, delusions did not worsen the prognosis in those diagnosed as suffering from mania or melancholia. Nevertheless, the prognosis was worse in boys with single paranoid delusions, or paranoid delusions in combination with auditory hallucinations of people, and worse for girls with delusions of exaltation in combination with other types of delusions.