To investigate the accuracy of the age-at-onset criterion in those who meet other DSM-5 criteria for attention-deficit hyperactivity disorder, using a prospective population cohort we compared four different approaches to asking those aged 25 years (n = 138) when their symptoms started. Receiver operating characteristic curves showed variation between the approaches (χ(3) = 8.99, P = 0.03); all four showed low discrimination against symptoms that had been assessed when they were children (area under the curve: 0.57–0.68). Asking adults to recall specific symptoms may be preferable to recalling at what age symptoms started. However, limitations to retrospective recall add to debate on the validity of ADHD age-at-onset assessment.

The case of Miss Hickman appears a very mysterious one in the light of the facts which have become known. An able, sane, sensible, athletic young woman, in the prime of life, and with no known antecedents of mental disorder, a qualified medical practitioner, holding a temporary hospital appointment, leaves the hospital one summer morning without notice, and is never seen or heard of again until her decomposed body is found, two months afterwards, hidden away in a thicket in Richmond Park. The evidence of suicide was conclusive, and at once an hypothesis is mooted that the responsibility of her position weighed so heavily upon her as to unhinge her mind. On this hypothesis is founded a further thesis concerning the unfitness of women to hold positions of responsibility, and especially their unfitness for the profession of medicine. Whether women are unfit to practise medicine need not be discussed here, but it is as well to point out the fatuity of the hypothesis on which the thesis is grounded. Apart from such instances as those of Queen Victoria and Catherine II, which go to show that certain women, at any rate, are capable of holding positions of responsibility even greater than that of house surgeon to a hospital, there is no evidence that Miss Hickman felt her responsibility unduly. As has often been pointed out in another part of this Journal, we are far too apt to speak of crimes as “motiveless” when all we are justified in saying is that we cannot discern an adequate motive for them. We have no surety that we know all the facts, and if all the facts were as well known to us as to the actors in these dramas, the probability is that the number of “motiveless” acts would be sensibly diminished. Every one of us has an outer life, known to all our associates, and an inner life, the whole of which is known to ourselves alone, though glimpses of it may be imparted to intimate confidential friends. To those who know our outer life only, many of our acts may, nay must, appear “motiveless,” although they may have been done after mature deliberation and consultation with our confidants; and if the whole of the inner life were known, it is probable that the residuum of “motiveless” acts would be very small.

As it has ever been the custom of man to act as if he were eternal, and lavishly to scatter the limited force which he embodies as though the supply were inexhaustible, it produces no unaccustomed surprise to witness the useless expenditure of force which is so frequently made at the present time. It may even, perhaps, be deemed a token of some modesty, that the being, who since his first formation has been continually occupied in metaphysical regions with the investigation of the origin of all things, should be content for a while to amuse himself with physical theories concerning his own origin. That which is to be regretted in the new and comparatively praiseworthy occupation is the old evil of hasty theorizing on the one hand, and on the other hand, the evil, scarcely less ancient, of an impetuous eagerness to demolish any theory, however plausible, which comes athwart a favourite prejudice. What though the anatomist does discover a very close resemblance and very slight differences between the structure of a gorilla and the structure of a human being; there is no need, on that account, that mankind in a feeling of injured dignity should angrily rouse up and disclaim the undesired relationship. Whatever may be said or written, it is quite plain after all that a man is not a gorilla, and that a gorilla is not a man; it is furthermore manifest that gorillas do not breed men now-a-days, and that we have not the shadow of any evidence to guide us in forming; an opinion as to what they may have clone in times past. The negative testimony of Du Chaillu, who says that he searched in vain in the gorilla region for any intermediate race or link between it and man, scarcely adds anything to the conviction of the non-existence of any such link, which has long been universally entertained.*

We assessed specificity protein 1 (SP1) and 4 (SP4) transcription factor levels in peripheral blood mononuclear cells and conducted a voxel-based morphometry analysis on brain structural magnetic resonance images from 11 patients with first-episode psychosis and 14 healthy controls. We found lower SP1 and SP4 levels in patients, which correlated positively with right hippocampal volume. These results extend previous evidence showing that such transcription factors may constitute a molecular pathway to the development of psychosis.