Published: 02/06/2005, Volume II5, No. 5958 Page 32

Stewart McCann of the University College of Cape Breton in Nova Scotia, Canada, has recently concluded that the younger you are when you achieve greatness, the shorter your life span.

He looked at 22 samples of high achievers like prime ministers, popes, supreme court justices, Nobel Prize- and Oscar-winners and found, in practically all these groups, an intriguing link between precocious achievement and poorer long-term physical health.

To explain the link between fast success and a quick exit, he suggests that young high-achievers are almost certainly pushy and score highest on 'type A' personality, characterised by competitiveness, excessive drive and an enhanced sense of urgency.

This finding fits in with the medical view from as far back as the 1950s - that one key risk factor for cardiovascular disease is labouring under a type A personality. Basically, the type A pattern refers to any person involved in an aggressive and incessant struggle to achieve more in less time.

Because they are so 'goal-directed', type As also suffer from irritation, hostility and an increased potential for anger. They eventually find that others around them are not travelling as fast as they are, and are getting in the way. As a result there is frustration at not getting expected results - followed by anger and adrenaline overload.

The problem with type As is that the self-conviction from which their incessant drive stems appears at times to verge on delusional.

What's fascinating about delusional leaders - and leaders or successful managers in general will tend to be type As - is that, unlike the ordinary patient, they can bend reality to fit in with their vision.

Is it possible that even Winston Churchill, during the darkest days of the Blitz when he was often the sole believer in a British victory, could have been described as a slightly delusional?

In the end, his implacable conviction helped save the country. Perhaps for our leaders the issue is not whether or not they are deluded but, if they are going to develop delusions, they should at least be helpful ones.

Dr Raj Persaud is consultant psychiatrist at South London and Maudsley trust and Gresham professor for public understanding of psychiatry.