[Delusional misidentifications. Symptoms and neuropsychological models]

[Delusional Misidentification Syndrom and Violent Behavior - Risk Assessment and Management]

OBJECTIVE AND METHOD

A case series of three patients with Delusional Misidentification Syndroms (DMS) and violent behavior is presented with respect to the correlation between DMS and violence as well as to the management of such occurrences.

RESULTS AND CONCLUSION

DMS could be one of the reasons for violent behavior of patients with psychiatric disorders. In such case violent behavior is not just restricted to intimates and relatives but also turns on non-familiar caregivers. DMS could be a risk factor for violent behavior and should therefore be registered with help of a nuanced psychopathological exploration at the time of clinical admission and in course of treatment. Moreover risk assessment tools and safety measures (e. g. medication, monitoring) could be considered for patients with DMS.

Grief and Mourning from the Perspective of the Person with a Dementing Illness: Beginning the Dialogue

While working with individuals with Alzheimer's disease and other dementing disorders presents many challenges for clinicians, none is more difficult than watching an individual who is cognitively impaired mourn the losses of life and those imposed by the dementing illness. There now is a body of literature on grief in caregivers, but little has been written to help clinicians understand or better support affected individuals who are experiencing multiple losses and yet whose insight, autobiographical memory, and connectedness to others is beginning to blur and fade. This article addresses current models of grief, examines the ability or inability of affected individuals to experience and resolve grief, and attempts to formulate questions that may ultimately allow clinicians and caregivers to better recognize and address the difficult issues of the grief response and mourning process in the person with dementing illness.

Clinical features of parricide in patients with schizophrenia

OBJECTIVE

This study aimed to investigate the factors associated with parricide in patients with schizophrenia who committed homicide.

METHOD

Among patients with schizophrenia who were in the National Institute of Forensic Psychiatry between November and December 2007, 88 patients who committed homicides were enrolled; 59 had committed parricide, and 29 had killed strangers. Medical charts, written expert opinions, written records of police or prosecutors, and court decisions were reviewed. Direct interviews with patients were also conducted.

RESULTS

Significant factors associated with parricide among homicidal patients with schizophrenia were living with the victim, female sex of the victim, and offense-provoking events including scolding, threatening forced hospitalisation, and forcing medication on the patient before the homicide. Capgras syndrome was present at a significantly higher rate in the parricide group than in the stranger group. Drug compliance at the time of the offence was low in both groups.

CONCLUSIONS

Untreated psychotic symptoms such as Capgras syndrome, living with elderly parents, especially mothers, and conflicts caused by victims' scolding, threatening forced hospitalisation, and forcing medication on the patients are associated with parricide among homicide offenders with schizophrenia.