These findings suggest that BPD is associated with complex impairments in dissociable cognitive processes mediated by circuitry encompassing the frontal lobes. These impairments may mediate some of the behavioural changes evident in BPD. Further work is needed to examine the specificity of these findings.

This book is essentially a report of a research project. The project is a survey of approximately 20% of the patients who had been in one of the special hospitals for a year or more at the time of the study. It concerns 296 patients, 241 men and 55 women. The aim was to provide a demographic, criminological, psychiatric and behavioural description of each patient. Data on each subject were collected from the case notes, an interview with the patient, a nursing representative, the patient's consultant, and lastly the research team made their own separate assessment of each patient's diagnosis, treatment and security needs.While there is a brief account of the administrative and philosophical background against which this study of psychiatric treatment in secure circumstances was conducted, and the method is clearly described, most of the book is taken up by a very detailed account of the findings. There are more than 100 tables of results. This style of presentation is unusual in a book, and indeed would not be commonplace in a scientific paper. Authors of such works tend to be asked to present their work rather more succinctly.The book really reads like the results chapters of a thesis or like a final report to a funding body. As such, it might be expected to be rather poor value for its price of £75.00 and also to be rather dull and repetitive. It is repetitive but I did not find it dull. Subject-matter of this kind cannot be dull. The detailed account of the severity and intractability of the problems presented by these patients will be of interest to psychiatrists with responsibility for the care of those with major psychiatric disorders, and will be essential reading for those involved in planning. While the article is on the whole densely written, with little comment, there are some telling observations, e.g. on page 62: 'It is easy to say that patients do not require maximum security. It is much more difficult to find a placement that meets their extensive therapeutic needs more successfully than their current placement' and on page 66: 'for almost 95% of psychotic patients the clinical team can see no likelihood of improvement over the next 5 years. In other words the question of placement for most of these patients will have to take account of Criminal Behaviour and Mental Health, 7, 95-105 1997 © Whurr Publishers Ltd 95