SEXUAL BEHAVIOR AND SECONDARY SEXUAL HAIR IN FEMALE PATIENTS WITH MANIC-DEPRESSIVE PSYCHOSES, AND THE RELATION OF THESE FACTORS TO DEMENTIA PRÆCOX

1. Observations are reported on 107 patients with recovery from two or more attacks. 2. Masculine pubic hair and mammary hair occurred with much less frequency in these patients than in those with dementia præcox, and with only a slightly greater frequency than in non-psychotic pregnant women. 3. In certain cases a close relation was found to exist between the character and adequacy of the previous sexual behavior, the age of onset of the psychosis, and the occurrence of these masculine types of hair growth. 4. Correlation of these three factors with the clinical picture on admission and the subsequent course after months or years in the hospital, and comparison with similar observations in dementia pnecox, seems to warrant the following conclusion: That in female patients with psychotic reactions having certain benign aspects, usually resembling manic excitement, a history of inadequate or peculiar sexual behavior, and often of illicit intercourse, together with early onset of the psychosis and the presence of masculine hair, indicates a malignant process and unfavorable outcome. Many such patients fail to recover from the first or second attack and follow a malignant course which cannot be differentiated from dementia præcox. Others follow an atypical course, with prolonged attacks and final chronicity, without very marked deterioration. Three illustrative cases are reported. 5. The biological significance of the findings is discussed. 6. Statistics on the number of attacks of manic-depressive psychosis are misleading when recovery from the first and subsequent attacks is not shown.