The offenders committed to local hospitals in 1962 and 1964 under a hospital order with restriction of discharge were followed up for 15 years with regard to subsequent court appearances, hospital admissions, and death. One hundred and forty-six were traced. Of these, 49 per cent had been diagnosed as mentally ill: most of this group were committed for violent offences. Thirty-five per cent were mentally subnormal: they were frequently committed for sexual offences, arson and property offences. Twelve per cent were diagnosed psychopathic: this group had a wide variety of committal offences.

Fourteen per cent of the mentally ill and 17 per cent of the mentally subnormal were still in hospital after 15 years, but 51 per cent of the mentally ill and 36 per cent of the mentally subnormal were released within three years. Sixty-one per cent of the psychopaths were released within two years. Few of the subsequent offences were serious in any of the diagnostic groups.

Since 1973 there has been a dramatic fall in restriction orders, especially for mentally subnormal patients.

All men receiving hospital orders (Section 60) in the UK in the year 1963–64 (excluding those receiving restriction orders (Section 60/65)) were followed up over 15 years with regard to (1) subsequent offences and convictions, (2) hospital admissions, and (3) death. Nine per cent of the patients involved could not be traced. Sixteen per cent had died by 1978, a quarter of them by suicide.

Of the mentally ill only 4 per cent subsequently committed serious offences (manslaughter, wounding, GBH, robbery, rape or arson), although a further 4 per cent committed assaults repeatedly. Sex crimes were uncommon. Among the mentally subnormal, 7 per cent committed serious sex crimes subsequent to committal. A further 9 per cent were considered to be persistent sex offenders and another 9 per cent were judged to be persistently violent. In general the mentally subnormal were much younger and were detained for much longer than the mentally ill. Since 1964 the use of hospital orders for the detention of such people has become much less frequent.

The best predictor of subsequent offences was found by multiple regression analysis to be the number of previous offences: this was especially true for acquisitive offences committed by the young. The mentally ill were less often reconvicted than the mentally subnormal.

There have been recent attempts to re-define those offenders who are sufficiently dangerous to justify a longer sentence for their current offence than is normally provided in law, but there is little information about the frequency with which serious sexual offenders are reconvicted. Follow-up studies of the re-conviction in the subsequent 24 years and 15 years of those found guilty of rape, incest, and unlawful sexual intercourse with girls under 13 in 1951 and 1961 have therefore been made. The present paper deals with those prosecuted for unlawful sexual intercourse with girls under 13. The results suggest that there is a low but more persistent tendency to re-conviction than is found in property offenders.

A stratified sample of 404 prisoners and ex-prisoners from three contrasted London prisons were interviewed: 40% were found to be excessive drinkers, although drunken offenders with very short sentences were excluded. The significant differences between heavy drinkers and the rest are considered in relation to history and social status.

Dr. Scott has outlined the varieties of treatment which have been suggested for psychopaths and some of the varieties which may be suitable for certain methods.

One of the most important questions in dealing with psychopaths is the prognosis. In 1948 two of us made a study (Stafford-Clark, Pond, Lovett-Doust, 1951) of a number of criminal psychopaths and a control group of ordinary criminals in prison by clinical and EEG methods, with the object of revealing the characteristics which most significantly distinguished psychopaths from others, and which were, therefore, most crucial in diagnosis. The psychopaths were carefully chosen in collaboration with two experienced prison medical officers. The later criminal behaviour of these psychopaths and controls is equally interesting, however, if we are to understand what the diagnosis implies (Gibbens, 1951). The third author (T.C.N.G.) has therefore been conducting a continuous follow-up, with the collaboration of the Prison Commission and Criminal Records Office. The results of the first follow-up, from 1948–1953, have been published (Gibbens, Pond and Stafford-Clark, 1955), and were reproduced in the transactions of the Royal Commission on the Law relating to Mental Illness (1957). The present paper deals with a further period of study, so that the follow-up is now from 1948-June, 1957.

One of the ways in which the psychiatrist differs from others who work with delinquents is in the importance attached to the sexual history of the offender. The contribution of psychiatrists in this respect has been mainly confined to a description of the emotional and dynamic aspects of sexual adjustment. But it is reasonable to suppose that if these emotional differences are as important as they seem to be from a study of individual cases, they would be reflected in differences in objective sexual behaviour, which are sufficiently definite to be used by criminologists in their more systematic studies. In the case of emotional relationships within the family, for example, psychiatric emphasis has induced criminologists to consider “broken homes” or “maternal separation” in a systematic way, but very few attempts have been made to relate the objective aspects of sexual behaviour and development with criminal behaviour. Even in the Gluecks' exhaustive study of five hundred delinquents and controls, which included psychiatric examination, sexual behaviour was not recorded, but only the presence or absence of sexual conflicts.