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In a previous paper, (1) the descriptive mental picture of juvenile paresis was described but no attempt was made to explain or interpret the psychological significance of the symptoms presented. Certain observations in a few cases, and detailed observations in one case studied over a four months period, seem of sufficient importance to justify their recording in this special report.
A statistical tabulation of mental symptoms recorded in the previous paper indicated the frequency of occurrence of various psychological features in juvenile paresis. This study was based on 43 cases personally studied, and 610 cases which have been published in the literature. It was shown that the most typical mental picture of juvenile paresis is a progressive dementia. In 653 reviewed cases, delusions were present in 19 per cent of cases; 9.5 per cent of the total number were expansive or grandiose, and 4.3 per cent were paranoid. Euphoria was present in 17.6 per cent of cases, and depression in only 8.6 per cent of cases. Rarely was a case depressed over a sufficiently long period of time to be regarded as a clinical reaction type. Infantile personal habits and mannerisms were frequent: conspicuous manual masturbation was commonly reported; 43.3 per cent of cases were untidy with regard to excretory habits; dancing, bouncing in bed, collecting waste and trinkets, stroking the hair, pulling at nose or ears, and grimacing were common, much more so than in adult paresis.
These figures are significant in indicating the differences in the mental picture from that observed in the adult type. They are suggestive of the special points to be studied in the psychology of the juvenile form, namely, the dementing process, the “petite” expansive delusions, the rarity of depression, and the frequency of infantile mannerisms. Only in individual case studies, however, is there any hope for the understanding of the meaning of these symptoms. But psychoanalytic investigation meets nearly unsurmountab