Women with autistic-spectrum disorder have significant differences in brain anatomy from controls, in brain regions previously reported as abnormal in adult men with the disorder. Some anatomical differences may be related to clinical symptoms.

BackgroundIt has been suggested that people with psychopathic disorders lack empathy because they have deficits in processing distress cues (e.g. fearful facial expressions).AimsTo investigate brain function when individuals with psychopathy and a control group process facial emotion.MethodUsing event-related functional magnetic resonance imaging we compared six people scoring ⩾25 on the Hare Psychopathy Checklist–Revised and nine non-psychopathic healthy volunteers during an implicit emotion processing task using fearful, happy and neutral faces.ResultsThe psychopathy group showed significantly less activation than the control group in fusiform and extrastriate cortices when processing both facial emotions. However, emotion type affected response pattern. Both groups increased fusiform and extrastriate cortex activation when processing happy faces compared with neutral faces, but this increase was significantly smaller in the psychopathy group. In contrast, when processing fearful faces compared with neutral faces, the control group showed increased activation but the psychopathy group decreased activation in the fusiform gyrus.ConclusionsPeople with psychopathy have biological differences from controls when processing facial emotion, and the pattern of response differs according to emotion type.

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ConclusionNotice ought to be taken of the discordance between staff and patients views (particularly in relation to consent and confidentiality) when attempting to detect and manage illicit drug use in psychiatric setting. This is particularly important when unconventional methods of detection (such as sniffer dogs) are being used. Moreover, clinicians and managers should be mindful that there currently exists very little (if any) data on the sensitivity and specificity of the use of sniffer dogs in situations such as this. Furthermore, there should be clear guidance on police involvement when illicit drug use is detected among in-patients. A balance needs to be struck between the patient's dignity and the right to confidentiality, and the maintenance of a drug-free environment. Declaration of interestNone. Funding detailed in Acknowledgements.