The relationship between psychiatric disorder and academic difficulty is clearly a complex one, for some severely disturbed students perform adequately, while clinically mildly disturbed individuals may fail completely. Emotional and psychiatric factors which could be associated with academic difficulty might include both the general factor of severity of disorder, and more specific factors related to the individual's personality motivation and attitude towards achievement and to his tutors. The nature of the demands, pressures and supports presented by the institution or by individual tutors is also likely to be of importance. In a previous psychometric study of all cases of academic and psychiatric difficulty from one year's intake at Sussex University (Ryle and Lunghi, 1968) it was shown that psychiatrically disturbed students in academic difficulty differed significantly from controls on the Nufferno Stress gain measure (Furneaux, 1965) whereas psychiatric patients who were coping academically scored in the same range as the controls. This difference was maintained when psychotic patients were removed from the academic difficulty group. No other psychometric scores distinguished between these two groups. The aim of the present paper is to make a preliminary attempt at defining what clinical features are associated with academic difficulty in a population of psychiatrically disturbed students. The sample studied consists of 38 male and 52 female psychiatric patients personally cared for by the author in a University Health Service encouraging direct consultation and tutor referral of students with personality or academic difficulties. Of these, 28 men and 37 women were the subjects of the previous study referred to above, the additional cases consisting of undergraduates of earlier intakes, and of 8 postgraduate students who had been personally assessed by the author over a two-year period.