a1 Institute of Psychiatry, De Crespigny Park, London
For 150 years the diagnostic concept at first called ‘moral insanity’ has been troubling psychiatric nosologists. Initially emphasis was laid on the affective disturbance in this condition, which was unaccompanied by intellectual impairment. Then its conformity to the idea of a degenerative process became prominent. At various times its relation to epilepsy, hereditary disease, and vice and crime has held the stage. Latterly little advantage has been taken of the information provided about personality by the investigations of psychologists.