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A study was designed to test the opinion that teenagers at risk of psychological disturbance can be identified on the basis of their family background. A copy of the general health questionnaire (28-question version) was sent to 322 17- and 18-year-olds registered with a semi-rural group practice. The records of all the 195 teenagers who replied, and those of their parents, brothers and sisters were examined and any record of chronic illness and psychological or social problems noted. Teenagers with family disruption, legal difficulties, parental marital problems or maternal psychiatric disorder recorded in the medical notes of their families were significantly more likely to have a high score on the general health questionnaire than those without such a record. Teenagers with high scores had attended the surgery more frequently during the previous year than those with low scores. Further work may enable more precise recording of family problems and enable a group at high risk of developing distressing psychological symptoms to be clearly identified. By early identification of this group, the general practitioner may be in a position either to prevent problems arising, or to intervene more effectively if a crisis develops.