Sixty-nine patients, each with a combined diagnosis of epilepsy and psychosis, were compared with 53 patients with a diagnosis of functional psychosis. The epileptic affective patients often lacked convincing psychotic features; ECT and lithium were rarely prescribed; only three showed evidence of bipolarity. The epileptic schizophrenic patients were judged to have the better premorbid personality; experienced more paranoid delusions and delusions of reference, and showed less catatonic features than the functional schizophrenic patients. The course of the epileptics' illness was more variable. The concept that the schizophrenia-like psychosis associated with epilepsy is a distinct nosological entity is supported, but not the suggestion of a relationship between affective psychosis and epilepsy.