King George III of England is most often remembered as being on the throne when the American colonies won their independence. Over the years, there has been much discussion about his physical and mental health. A new analysis now confirms that he suffered from a mental illness.

King George III was born in London in 1738 to Frederick, Prince of Wales, and Augusta of Saxe-Gotha. His father died in 1751, and he assumed the throne in 1760 after the death of his grandfather, George II. In 1761, he married Charlotte of Mecklenburg-Strelitz and they had 15 children. The Revolutionary War with the American colonies, subsequent political fallout and family quarrels were a stressful period. King George suffered serious illnesses from 1788 to 1789 and again in 1801. By 1810, he was no longer fit to serve as monarch, and his oldest son took control as Prince Regent. King George remained ill until his death at Windsor Castle on Jan. 29, 1820.

The King’s symptoms included agitation, rambling incoherent speech, episodes of violence and sexual impropriety. The standard treatment for “insanity” at the time was restraint. When the science of psychiatry was developed, it was proposed that the king suffered from manic depressive psychosis. That idea was later dismissed and another theory became widely accepted.

Early psychiatrists thought that King George III may have suffered from a rare genetic disease called porphyria. Porphyrins are a compound in the body required for the production of hemoglobin, the molecule that transports oxygen in the blood. Accumulating high levels of porphyrins can affect the nervous system, leading to sudden porphyria attacks that can be life-threatening. In addition to physical symptoms like abdominal swelling, chest pain and vomiting, porphyria can also cause mental changes like hallucinations, paranoia, anxiety and seizures. However, recent reviews of the king’s medical records revealed little evidence to support a diagnosis of porphyria.

In a new study, scientists used machine learning techniques that allow computers to learn from the data they collect. After comparing writings of people with and without mental illnesses, computers have learned to differentiate the writings of people with bipolar disorder, schizophrenia and different types of dementia from normal controls. Written correspondence between King George and parliamentarians have been preserved, and they suggest he was engaged in political events. Scientists compared letters that were written before, during and after historically documented episodes of the king’s mental derangement using features such as sentence structure, the richness of the vocabulary and repetition of words.

The study revealed remarkable differences in the letters King George wrote when he was healthy compared to those he wrote during periods of mental derangement. Letters written at times of mental disturbance were less complex and featured reduced vocabulary, fewer distinct word types, and greater redundancy and predictability.

Given what we know from King George’s medical records and this new analysis, it is likely that he suffered from a mental illness called acute mania. It would be interesting to use similar analysis on other historical figures to establish and diagnose their mental states.

Medical Discovery News is hosted by professors Norbert Herzog at Quinnipiac University, and David Niesel of the University of Texas Medical Branch. Learn more at www.medicaldiscoverynews.com.

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