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This investigation concerns the mental changes associated with Lewy bodies. Lewy bodies are inclusion bodies found in nerve cells and are characteristic of idiopathic Parkinson's disease. It has also been suggested that they may occur as a normal ageing change. Previous literature concerning the psychiatric symptoms of Lewy body disease is reviewed. Dementia and parkinsonism‐associated depression have been previously recognized. For this study the psychiatric histories of two groups of autopsied mental hospital patients were compared; one group with Lewy bodies, and one group without Lewy bodies. There were 212 autopsies. Of these, 15 had Lewy bodies and 197 did not. Clinical and neuropathological descriptions of those with Lewy bodies are given. Findings are also presented in tabulated form, and the groups are compared statistically. Clinical diagnosis of Parkinson's disease and admission with a paranoid diagnosis were the findings most associated with Lewy bodies. It is suggested that paranoia may sometimes be an early symptom of Lewy body disease. The problem of patients with psychosis who subsequently develop idiopathic Parkinson's disease is discussed. Such patients could be misidentified and mistreated because of being diagnosed as drug‐induced parkinsonism.

This study concerns differences between Alzheimer's disease in the old and the young. Literature differentiating Alzheimer's disease from ‘senile dementia’ is reviewed. Two groups of mental hospital patients with Alzheimer brain changes at autopsy are compared. They comprised the 17 oldest and 17 youngest of the 56 ptients with definite Alzheimer changes in a series of 212 consecutive autopsies. The younger group had been first hospitalized at later ages than the older group, and were more likely to have been demented at admission. The older group had mostly been diagnosed as schizophrenic (mainly paranoid) on admission. Neuropathologically the younger group showed more severe Alzheimer changes of all kinds. The changes in the older group tended to be limited to the hippocampus, whereas in the younger group they showed extension into the frontal and occipital cortex and were also found in subcortical gray matter. Lipofuscin was more abundant in the older group, so that a discrepancy between very severe Alzheimer changes and less abundant lipofuscin characterizes the younger cases.

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