Postmortem analysis of brain chemistry and anatomy in the study of psychiatric disorders has enjoyed renewed interest recently. There are myriad difficulties in establishing a brain bank, including proper diagnosis and confounding neuropathology. These difficulties may become more pronounced in a long-term domiciliary facility. In order to begin to address neuropathologic considerations, we performed neuropathological examinations on each patient included in our bank of 20 brains. Forty-five per cent of all patients had significant and unexpected neuropathology. Selection of patients to be included in postmortem studies requires careful screening to enhance accurate neuropathological assessment.