Imaging Brain Structure and Function in Schizophrenia

Attempts to define a personality profile of individuals disposed principally to self-serving and antisocial behaviour can be traced at least as far back as Pinel's concept of 'manie sans delire'.1 Rush2 relabelled it as 'moral alienation of the mind', and contributed strongly to the Anglo-American conception of psychopathy as predominantly antisocial. Prichard3 concerned himself with the question of antisocial actions under the control of the will, and stimulated a debate that shaped the concept of criminal responsibility, though his term 'moral insanity' had a limited lifespan. Subsequently, Partridge4 suggested the designation 'sociopathy' for personality disturbances whose outstanding feature is antisocial behaviour. Cleckley,5 in his monograph The Mask of Sanity, proposed the use of the term 'psychopathy' (which had been coined by Koch,6 in 1891) for individuals showing lifelong maladaptive behaviour not caused by neurosis, psychosis or mental handicap. Cleckley's definitions were developed in the diagnostic and statistical manual of mental disorders (DSM) and International Classification of Diseases (ICD) schemes.