Though pubertal insanity is rare it is important not only because many patients die and others are left permanently demented or imbecile, but also because in many of those who seemingly recover the attack is a warning of liability to mental breakdown later in life. Since the true cause of insanity is largely within the individual, is part and parcel of his mental makeup, depends relatively little on the mere accidents of his external life, his environment, and much on his ancestral history, and since the exciting causes merely give opportunity for insanity to arise, any mental abnormality occurring during the developmental period is of importance, however trifling it may seem in itself, as indicating mental instability or a tendency toward deviation from the normal, which under proper education may be corrected, but which if left uncorrected will certainly lead to disaster in the future.
Mental disease appearing in childhood,
BURR CW. INSANITY AT PUBERTY. JAMA. 1905;XLV(1):36–39. doi:10.1001/jama.1905.52510010036001k
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