1
|
Rodre S, Sturup J, Masterman T. Crime-scene and offender characteristics in conventional and nonconventional stranger homicides committed by male offenders in Sweden. MEDICINE, SCIENCE, AND THE LAW 2024:258024241255779. [PMID: 38801655 DOI: 10.1177/00258024241255779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
In Sweden, from 1990 to 2013, most homicides occurred between family members, friends or acquaintances: the annual rate of incidents between unacquainted offenders and victims ranged between 8% and 13%. In the majority of these "stranger homicides," three common motives, as defined by the precipitating event, could be identified: homicides resulting from a spontaneous altercation; homicides committed in the context of a robbery or burglary; and homicides committed in the context of a gangland conflict. The remaining minority-with uncommon or indiscernible motives-could, nonetheless, be categorized according to their nonconventional distinguishing feature: homicides characterized by the offender's ostensibly mentally aberrant behavior; homicides committed in the context of a hate offense or politically motivated offense; homicides committed in the context of a sexual offense; and homicides committed in the context of a mass killing or series of homicides. In this registry-based study of 224 incidents, "conventional" stranger homicides, defined by their commonplace motive, were compared with "nonconventional" stranger homicides, defined by their lack of such motive. The former were more often committed with an accomplice, against a male victim, whereas the latter were more often committed in a public place, after contact initiated by the offender. In the latter, offenders were less often intoxicated at the time of the offense and more often adjudged to suffer from a severe mental disorder. The subcategory of nonconventional stranger homicides characterized by the offender's ostensibly mentally aberrant behavior corresponded largely to both the archetypal stranger-homicide construct and the popular notion "act of madness."
Collapse
Affiliation(s)
- Sara Rodre
- Department of Forensic Psychiatry, National Board of Forensic Medicine, Huddinge, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Huddinge, Sweden
| | - Joakim Sturup
- Department of Clinical Neuroscience, Karolinska Institutet, Huddinge, Sweden
- Swedish Police Authority, Stockholm, Sweden
| | - Thomas Masterman
- Department of Forensic Psychiatry, National Board of Forensic Medicine, Huddinge, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|
2
|
Antar AY. Guilty or not guilty by reason of insanity? a comparative study of murderers referred for psychiatric examination by court order. HEALTH & JUSTICE 2023; 11:35. [PMID: 37668924 PMCID: PMC10478500 DOI: 10.1186/s40352-023-00230-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/05/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Some murders are committed under the influence of a psychotic state resulting from a mental disorder, mainly schizophrenia. According to the law in many countries, people with mental disorders do not have criminal responsibility. They are defined as not guilty due to insanity (insanity defense) and therefore cannot be punished. In Israel, in recent years, more lawyers are requesting psychiatric opinions for the murder defendants they represent. This study aims to explore the differences between two groups of murderers: individuals who committed murder and were found not guilty by reason of insanity (NGRI) and individuals who committed murder and were found responsible and guilty. The comparison is made from a broad perspective by examining sociodemographic factors and psychiatric factors as well as criminological and forensic factors. METHODS This study, conducted in Israel, analyzes the sociodemographic and forensic differences between 72 individuals who committed murder and were found not guilty by reason of insanity (NGRI) and 56 individuals who committed murder and were found responsible for their actions and fit to stand trial (guilty). RESULTS The findings show that NGRI participants were more likely to be from central areas, to be Jewish (rather than Arab), to be diagnosed with schizophrenia and have a background of hospitalizations before committing the murder, to have remained at the murder scene and/or called for help, and to be less likely to have committed the murder with a partner. CONCLUSIONS The study's findings are explained and the limitations discussed. The findings add to the existing knowledge base about murder by reason of insanity and the differences between NGRI and criminal murderers. The characteristics of the NGRI group found here can help to identify risk groups and to develop and implement prevention programs for people with mental disorders who are at risk of violent behavior.
Collapse
Affiliation(s)
- Anat Yaron Antar
- Department of Criminology, Max Stern Yezreel Valley College, Jezreel Valley, Israel.
| |
Collapse
|
3
|
Ghosh CC, McVicar D, Davidson G, Shannon C, Armour C. Exploring the associations between auditory hallucinations and psychopathological experiences in 10,933 patient narratives: moving beyond diagnostic categories and surveys. BMC Psychiatry 2023; 23:307. [PMID: 37131149 PMCID: PMC10155450 DOI: 10.1186/s12888-023-04780-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 04/12/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Previous research suggests that auditory hallucinations are prevalent within both the clinical and general populations. Yet, we know little about how these phenomena are associated with other psychopathology symptoms and experiences. The current study aids investigations towards preventing, predicting and more effectively responding to such distressing occurrences. There have been substantial efforts in the literature to propose models of auditory hallucination and attempts to verify them. However, many of these studies used survey methods that restrict the person's responses to a set of pre-defined criteria or experiences and do not allow exploration of potential important other symptoms beyond them. This is the first study to explore the correlates of auditory hallucination using a qualitative dataset consisting of unrestricted responses of patients about their lived experiences with mental illness. METHOD The study used a dataset consisting of 10,933 narratives from patients diagnosed with mental illnesses. For analysis, the study used correlation on the text-based data. This approach is an alternative to the knowledge-based approach where experts manually read the narratives and infer the rules and relationships from the dataset. RESULT This study found at least 8 correlates of auditory hallucination (small correlation coefficients), with the unusual ones being "pain." The study also found that auditory hallucinations were independent of obsessive thoughts and compulsive behaviours, and dissociation, in contrast with the literature. CONCLUSION This study presents an innovative approach to explore the possible associations between symptoms without the restrictions of (or outside the confines of) traditional diagnostic categories. The study exemplified this by finding the correlates of auditory hallucination. However, any other symptom or experience of interest can be studied similarly. Potential future directions of these findings are discussed in the context of mental healthcare screening and treatment.
Collapse
Affiliation(s)
| | - Duncan McVicar
- Queen's Management School, Queen's University Belfast, Belfast, UK
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
| | - Ciaran Shannon
- IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, UK
| | - Cherie Armour
- School of Psychology, Queen's University Belfast, Belfast, UK.
| |
Collapse
|
4
|
Barbieri C, Rocca G, Bosco C, Tattoli L, Grattagliano I, Di Vella G. The Doppelgänger phenomenon and death: a peculiar case of homicide by a subject with first-episode psychosis. Forensic Sci Res 2023; 7:798-802. [PMID: 36817250 PMCID: PMC9930753 DOI: 10.1080/20961790.2022.2055827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
The Doppelgänger phenomenon refers to the experience of a direct encounter with one's self, characteriswed by: (i) the perception of a figure with one's own identical physical features; or (ii) the apprehension that the perceived figure shares the same personality and identity. The Doppelgänger does not only look like the same person, it is his/her double. The perceptual element is usually a hallucination, although occasionally a false perception of an actual figure may be involved. This phenomenon has been described in individuals suffering from overwhelming fear, severe anxiety or intoxication, epilepsy, as well as in the sleep-wakefulness transition. It has also been reported in major psychoses. The fear of imminent death often precedes the Doppelgänger experience. This report presents the case of a 30-year-old man, Mr. Y, who was stabbed to death by Mr. X, his "double". The aggressor and his victim, although not related, were truly doubles; remarkably, they shared the same name and surname, age, professional activity and place of work. Moreover, they attended the same sports center but barely knew each other. The forensic psychiatric evaluations in Mr. X, subsequent to the crime committed, were suggestive of a psychotic condition. This case is unique in the scientific literature. In the most serious psychotic forms, the issue of the "double" calls into question not only the dissociative processes involved in the etiopathogenesis of the disorder, but also bio-psycho-social elements, as well as personal data in this case, which made the victim and the aggressor "identical". In the context of psychopathological functioning, the delusional mood (Wahnstimmung) that precedes the development of delirium is a sort of gateway to an impending psychotic illness, involving delusional awareness or mood (atmosphere). In psychosis, splitting is the main issue and this influence is seen as an evil, foreign, apocalyptic and unknown side no longer recognised as belonging to the self even in a physical sense. In such a situation, it is felt that the only way to survive is by suppressing one's double as a defense against disorganisation of the self.
Collapse
Affiliation(s)
- Cristiano Barbieri
- Section of Forensic Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - Gabriele Rocca
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Caterina Bosco
- Department of Public Health and Pediatric Sciences, Legal Medicine Unit, University of Turin, Turin, Italy,CONTACT Caterina Bosco
| | - Lucia Tattoli
- S.C. Medicina Legale U, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Ignazio Grattagliano
- Department of Education, Psychology, Communication University Aldo Moro of Bari, Bari, Italy
| | - Giancarlo Di Vella
- Department of Public Health and Pediatric Sciences, Legal Medicine Unit, University of Turin, Turin, Italy
| |
Collapse
|
5
|
He Y, Gu Y, Yu M, Li Y, Li G, Hu Z. Research on interpersonal violence in schizophrenia: based on different victim types. BMC Psychiatry 2022; 22:172. [PMID: 35260126 PMCID: PMC8903153 DOI: 10.1186/s12888-022-03820-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 02/28/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Schizophrenia is one of the most common severe mental disorders associated with an increased risk of violence. The present study compares the demographical, clinical, and criminological characteristics of the patients with schizophrenia who committed different types of violence to relatives, acquaintances, or strangers. METHOD Archives of the violent offenders with schizophrenia referred to forensic psychiatric assessments from January 2015 to December 2019 in the West China Forensic Medicine Assessment Center in China were analyzed. The demographic information, mental illness history, and criminological characteristics of the offenders were collected. The clinical symptoms, previous violent behaviors, and social deficits were also evaluated. One-way ANOVA, Kruskal-Wallis test, Chi-square test, and logistic regression analysis were enrolled to do the statistical analysis. RESULTS The study enrolled 332 cases: 165 cases (49.7%) in the acquaintance victim group (AV), 96 cases (28.9%) in the relative victim group (RV), and 71 cases (21.4%) in the stranger victim group (SV). The multinomial logistic regression analysis revealed that older patients were less likely to attack relatives (OR = 0.966, 95% CI = 0.944-0.990; p = 0.005), and strangers, (OR = 0.971, 95% CI = 0.944-0.998; p = 0.034). Patients who lived with others were more inclined to attack relatives (OR = 15.057, 95% CI = 3.508-64.628; p < 0.001). Additionally, employed patients were more likely to attack strangers (OR = 2.034, 95% CI = 1.036-3.994; p = 0.039). The regression equation did not include psychiatric symptoms. For RV and AV victims, the risk of death was higher compared to that of SV victims (OR = 13.778, p < 0.001; OR = 2.663, p = 0.014). CONCLUSION In the interpersonal violence cases committed by schizophrenia patients, the victim type correlates with demographic characteristics of offenders such as living situation, age, and employment status, but not with the psychiatric symptoms. The majority of victims were acquaintances and relatives, and the relative victims having more severe injuries. In order to decrease interpersonal violence, especially violent crimes, more people, especially family members and neighbors, should be educated about symptoms of schizophrenia, the ways to communicate with the patients, and the methods for crisis management.
Collapse
Affiliation(s)
- Yong He
- grid.13291.380000 0001 0807 1581Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan 610041 Chengdu, China
| | - Yan Gu
- grid.13291.380000 0001 0807 1581Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan 610041 Chengdu, China
| | - Meiling Yu
- grid.13291.380000 0001 0807 1581Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan 610041 Chengdu, China
| | - Yan Li
- grid.13291.380000 0001 0807 1581Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan 610041 Chengdu, China
| | - Gangqin Li
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan, 610041, Chengdu, China.
| | - Zeqing Hu
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan, 610041, Chengdu, China.
| |
Collapse
|
6
|
Nielssen O, Large M. Homicides in psychiatric hospitals: Absence of evidence or evidence of absence? CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2022; 32:60-66. [PMID: 35034397 DOI: 10.1002/cbm.2226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 12/19/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Highly publicised cases of homicide in a psychiatric hospital have raised concerns about the safety of such hospitals. AIMS To identify individual case reports of homicides by inpatients within psychiatric hospitals in order to update a 2011 study. METHODS A systematic search of the academic literature between 2010 and 2020, information seeking from service leaders in each state and territory of Australia and in New Zealand, and a search of public records in Australia and New Zealand. RESULTS The literature search revealed only one recent paper describing a homicide by a patient in a psychiatric ward. Contact with forensic psychiatrists across Australia and New Zealand yielded four cases of inpatient homicide that took place between 2010 and 2017 in Australia, and none in New Zealand. Public record searching did not add to this count. This compares to 11 inpatient homicides by 10 patients between 1985 and 2011. CONCLUSIONS Homicides in psychiatric hospitals seem to remain rare, however, there is no consistent central documentation of these events in Australasia so it is hard to be confident about the figures. Internationally, there is similarly little centralisation of evidence. Standardised methods of recording and reporting such deaths might assist the understanding and prevention of homicides in psychiatric hospitals.
Collapse
Affiliation(s)
- Olav Nielssen
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, New South Wales, Australia
- St Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Matthew Large
- University of New South Wales, Sydney, New South Wales, Australia
- Prince of Wales Hospital, Randwick, New South Wales, Australia
| |
Collapse
|
7
|
Provoost E, Raymond S, Gasman I. Homicides committed by delusional patients in the early 20th and 21st centuries: A study conducted in a French secure unit. J Forensic Sci 2021; 67:265-274. [PMID: 34634145 DOI: 10.1111/1556-4029.14892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 08/06/2021] [Accepted: 08/26/2021] [Indexed: 11/28/2022]
Abstract
Homicides committed by delusional patients are the object of a rich scientific literature, which puts the risk of such acts occurring into perspective when analyzing the offenders' sociodemographic and clinical characteristics. However, few articles detail the themes and mechanisms underlying those patients' delusions. To help bridge that gap, the authors conducted this retrospective descriptive study, including two samples of delusional homicidal patients, one from near present day and one from nearly a century ago. This study considered similarities observed in the literature (such as patients' sociodemographic profile, clinical data, and acting-out dynamics), but also explored the characteristics of delusion. In the 2015-2019 sample, the typical patient profile was: single male (31.5 years old on average), without child, unemployed, and with psychiatric history (56.6%). Most patients suffered from schizophrenic disease (83%) with non-systematized delusions exhibiting multiple themes in 80% of cases. Four principal types of delusion were observed: persecutive (100%), mystical (43.3%), megalomaniac (30%), and bodily (30%). The mechanisms were interpretative, hallucinatory, and intuitive. There was a societal influence in 23.3% of the cases (most often terrorist acts). The 1910-1914 historical sample revealed several differences: patients were older, more often married and employed. There were more diagnoses of chronic delusional disorder (30%). Persecutory delusion was constant (100%), and the other delusional themes were the "intimate relationship" type (50%)-jealousy, erotomanic-and the bodily type (40%). Additional studies are useful in order to reinforce our findings, and to further investigate the possibilities of prevention.
Collapse
Affiliation(s)
| | - Sophie Raymond
- SMPR La Santé, GHU Paris Psychiatrie et Neuroscience, Paris, France
| | - Ivan Gasman
- UMD Henri Colin, GH Paul Guiraud, Villejuif, France
| |
Collapse
|
8
|
Mezey G, Rowe R, Adshead G. Impact of homicide by a psychiatric patient on forensic psychiatrists: national survey. BJPsych Bull 2021; 45:183-189. [PMID: 35346405 PMCID: PMC9059313 DOI: 10.1192/bjb.2020.96] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIMS AND METHOD To explore the experiences and support needs of consultant forensic psychiatrists, whose patients had committed homicide while under their care. We circulated a survey to all forensic psychiatrists in the UK, through the Royal College of Psychiatrists, asking about their experiences of a homicide by a patient under their care. Respondents were invited to discuss their experiences further in a structured telephone interview and themes were identified from these discussions. Data were analysed quantitatively and qualitatively. RESULTS One-third of the 86 respondents had had at least one patient who had committed a homicide while under their care. Of these, over three-quarters (78%) reported that the homicide had a significant impact on their personal life, professional life and/or mental/physical health. For some respondents, the impact was severe and long term. Respondents generally felt that they would have been helped by receiving more support in the aftermath of the homicide. CLINICAL IMPLICATIONS Greater recognition is needed of the impact on treating psychiatrists of homicide by a patient and more support is needed for affected clinicians. Further research is necessary, including the effects of such events on colleagues in other specialties and examination of the costs versus the benefits of mandatory inquiries after homicides.
Collapse
Affiliation(s)
- Gillian Mezey
- St George's, University of London, UK.,South West London and St George's Mental Health NHS Trust, UK
| | - Renarta Rowe
- Birmingham and Solihull Mental Health NHS Foundation Trust, UK
| | - Gwen Adshead
- West London NHS Trust, UK.,Central and North West London NHS Foundation Trust, UK
| |
Collapse
|
9
|
Hachtel H, Nixon M, Bennett D, Mullen P, Ogloff J. Motives, Offending Behavior, and Gender Differences in Murder Perpetrators With or Without Psychosis. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:3168-3190. [PMID: 29759034 DOI: 10.1177/0886260518774304] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Little is known whether differences exist in motivation and reactive/instrumental offense behaviors between murder offenders with and without psychotic disorder. To contribute to better prevention strategies, the aim of this study was to investigate offense characteristics in murder offenders with a psychotic, nonpsychotic or no psychiatric diagnosis, and whether these factors differ according to sex. This data study examined the population of murder offenders between 1997 and 2005 (N = 435) in Victoria, Australia. Apparent motive for murder was allocated to one of six classifications. Assignations of reactive versus instrumental offense categories, co-offending, victim-offender relationship were determined by review of case material. Mental health service usage and prevalence of mental illnesses were identified through data with the statewide register of contacts with the public mental health system. Of the 435 offenders, 43 (9.9%) had been diagnosed with a psychotic illness. Gender differences between and within offenders with and without a psychotic disorder were analyzed. Murder offenders with a psychotic disorder were 3.19 (95% confidence interval [CI] = [1.27, 8.03]) times more likely to be motivated by revenge than nonpsychotic offenders and those with no diagnosis (odds ratio [OR] = 2.46, 95% CI = [1.10, 5.53]). The diagnostic groups did not differ on premeditation of their offenses or prior convictions. Perpetrators with psychotic illness were significantly more likely to kill family members and others known to them. It appears that for the psychotic disorder group, the perception of having been wronged in some way is a potential risk marker for planning and committing a serious offense. Care should be taken to improve adherence and access to care to avoid possible future serious violence especially in female patients with a high burden of mental illness like schizophrenia or severe mood disorders.
Collapse
Affiliation(s)
- Henning Hachtel
- Swinburne University of Technology, Clifton Hill, Victoria, Australia
- University of Basel, Basel, Switzerland
| | - Margaret Nixon
- Swinburne University of Technology, Clifton Hill, Victoria, Australia
| | | | - Paul Mullen
- Monash University, Clayton, Victoria, Australia
| | - James Ogloff
- Swinburne University of Technology, Clifton Hill, Victoria, Australia
| |
Collapse
|
10
|
Markopoulou M, Karakasi V, Garyfallos G, Pavlidis P, Douzenis A. Research findings on Greek forensic patients found not guilty by reason of insanity. A juxtaposition of patients who committed a criminal offense during their first psychotic episode with those who did so later in the course of their illness. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2021; 75:101673. [PMID: 33517142 DOI: 10.1016/j.ijlp.2021.101673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 12/07/2020] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
The aim of this study was to compare the baseline characteristics (demographic, psychiatric-psychopathological and legal) among Greek forensic patients found not guilty by reason of insanity. The first step of this approach being differentiating patients who committed a criminal offense during their first psychotic episode from the ones who did so later in the course of their illness. All patients were hospitalized in the Department of Forensic Psychiatry (DFP) of the Psychiatric Hospital of Thessaloniki (PHT) from January 2015 to January 2020 and were examined in order to be included in the study. The final research sample consisted of 78 patients (70 identifying themselves as males and 8 identifying themselves as females) aged 18 and older, 21 of whom committed a criminal offense during their first psychotic episode (FEP, N = 21) and 57 did so later on in the course of their illness (Course, N = 57). Data were collected from multiple sources and several psychometric tools were used (Mini International Neuropsychiatric Interview-M.I.N·I, Positive And Negative Syndrome Scale-PANSS, Addiction Severity Index-ASI, CAGE Questionnaire, Hostility and Direction of Hostility Questionnaire-HDHQ, Global Assessment of Functioning-GAF and Aggression Questionnaire). Comparing the two groups (FEP vs. Course) we found that patients in FEP were younger, had experienced stressful life events in the last 24 months, committed more serious violent crimes, and more frequently attempted suicide after the crime. Their victims were usually members of their family. The main psychometric disparities between the two groups were found in the "Hostility" score of the Aggression questionnaire, and the items "Criticism of Others" and "Paranoid Hostility" of the HDHQ questionnaire, where patients in FEP scored lower. Patients in FEP scored significantly higher in items P1 (delusions), P4 (excitement), P6 (suspiciousness/persecution) and P7 (hostility) of the PANSS scale. No statistically significant differences were found between the two groups regarding their evaluation with the CAGE, ASI or GAF questionnaires. When comparing the patients' present scores in PANSS scale, the patients in FEP had lower total scores in the Positive and the General Psychopathology subscales. Both groups showed significant improvement during hospitalization in all scales (PANSS & GAF), except for the Negative Subscale of the PANSS scale. Through logistic regression analysis, we found that patients in FEP were younger, more likely to have recently experienced stressful life events and more likely to have assaulted a member of their family. Patients with higher scores in the "Hostility" subscale of the Aggression questionnaire were found to remain at risk for committing a crime during the course of their illness. These findings underline the need to design and develop specialized mental health services in order to identify and treat patients involved in violent crime in a timely and effective manner addressing their multiple needs.
Collapse
Affiliation(s)
- M Markopoulou
- Department of Forensic Psychiatry, General Hospital of Thessaloniki G. Papanikolaou, Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece.
| | - V Karakasi
- 3(rd) Department of Psychiatry, Aristotle University of Thessaloniki, Medical School, AHEPA Hospital, Thessaloniki, Greece
| | - G Garyfallos
- 2(nd) Department of Psychiatry, Aristotle University of Thessaloniki, General Hospital of Thessaloniki G. Papanikolaou, Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece
| | - P Pavlidis
- Laboratory of Forensic Sciences, Democritus University of Thrace, Medical School, Alexandroupolis, Greece
| | - A Douzenis
- 2(nd) Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, "Attikon" Hospital, Athens, Greece
| |
Collapse
|
11
|
Whiting D, Lichtenstein P, Fazel S. Violence and mental disorders: a structured review of associations by individual diagnoses, risk factors, and risk assessment. Lancet Psychiatry 2021; 8:150-161. [PMID: 33096045 DOI: 10.1016/s2215-0366(20)30262-5] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 02/08/2023]
Abstract
In this Review, we summarise evidence on the association between different mental disorders and violence, with emphasis on high quality designs and replicated findings. Relative risks are typically increased for all violent outcomes in most diagnosed psychiatric disorders compared with people without psychiatric disorders, with increased odds in the range of 2-4 after adjustment for familial and other sources of confounding. Absolute rates of violent crime over 5-10 years are typically below 5% in people with mental illness (excluding personality disorders, schizophrenia, and substance misuse), which increases to 6-10% in personality disorders and schizophrenia spectrum disorders, and to more than 10% in substance misuse. Past criminality and comorbid substance misuse are strongly predictive of future violence in many individual disorders. We reviewed national clinical practice guidelines, which vary in content and require updating to reflect the present epidemiological evidence. Standardised and clinically feasible approaches to the assessment and management of violence risk in general psychiatric settings need to be developed.
Collapse
Affiliation(s)
- Daniel Whiting
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Seena Fazel
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.
| |
Collapse
|
12
|
Caractéristiques et particularités des homicides commis par des schizophrènes. ANNALES MEDICO-PSYCHOLOGIQUES 2020. [DOI: 10.1016/j.amp.2020.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
13
|
Ahonen L, Loeber R, Brent DA. The Association Between Serious Mental Health Problems and Violence: Some Common Assumptions and Misconceptions. TRAUMA, VIOLENCE & ABUSE 2019; 20:613-625. [PMID: 29333994 DOI: 10.1177/1524838017726423] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The media, the general public, and politicians often emphasize that mental illness is a precursor and a cause of violence, particularly emphasizing an assumed relationship between mental illness, including psychopathy and psychosis, and the use of guns to commit violence. We report which individuals with serious mental health problems have an increased risk to commit violence (including gun violence). Second, we answer the question to what extent serious mental health problems explain most violence and especially gun-related violence. And what is the opinion of experts on these questions? Third, we review which effective screening instrument can help to identify individuals with mental health problems who are at risk to carry a gun and commit violence. For policy makers and legislators, this article points out that most psychiatric disorders are not related to violence, with some exceptions such as schizophrenia and bipolar disorder, and often only in conjunction with substance use. We show that the attributable risk of mental illness to explain violence in general is low. We also emphasize that conduct disorder in late childhood or adolescence is a better predictor of violence than is mental illness at a later age. Empirically based screening methods to identify individuals with mental health problems who are prone to violence appear to have limited utility. Implications are discussed for clinicians and practitioners working in the justice system, researchers, and policy makers.
Collapse
Affiliation(s)
- Lia Ahonen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Örebro University, Örebro, Sweden
| | - Rolf Loeber
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - David A Brent
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
14
|
Abolarin J, McLafferty L, Carmichael H, Velopulos CG. Family Can Hurt You the Most: Examining Perpetrators in Multiple Casualty Events. J Surg Res 2019; 242:172-176. [PMID: 31078902 DOI: 10.1016/j.jss.2019.04.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/07/2019] [Accepted: 04/04/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Recently, multiple-homicide events, particularly mass shootings, have become a focus of media attention. We hypothesize that many multiple homicides are related to domestic conflict and suicidality. MATERIALS AND METHODS We analyzed multiple-homicide events (involving two or more victims) in the National Violent Death Reporting System from 2003 to 2015, including those that were followed by suicide of the perpetrator. We characterized circumstances of these events and compared victims with those found in single-homicide events. RESULTS We identified 2425 multiple-victim incidents involving a total of 5424 homicide victims (9.3% of all homicide victims in National Violent Death Reporting System). Of these events, 14.1% (n = 341) were homicides followed by suicide of the perpetrator. Many multiple homicides involved intimate partners or family members of the victims (n = 741, 30.6%). Few of these events were related specifically to a mental health crisis (n = 39, 2.3%), resulting in the deaths of multiple strangers. Even in mass homicide events (more than four victims), many involved the death of an intimate partner or family member of the perpetrator (n = 14/31, 45.2%). Risk of homicide-suicide increased as the number of victims in the incident increased. CONCLUSIONS In our examination of multiple-homicide events, we found that many involve the death of the intimate partner and/or family members of the perpetrator, even for events with more than four victims. Although the scenario of a perpetrator with mental health issues going on a "shooting rampage" and murdering multiple strangers is commonly invoked in mass homicide incidents, it is rare overall.
Collapse
|
15
|
Kachouchi A, Sebbani M, Salim S, Adali I, Manoudi F, Amine M, Asri F. Facteurs de risque de passage à l’acte d’homicide chez des patients marocains atteints de schizophrénie. Encephale 2018; 44:409-414. [DOI: 10.1016/j.encep.2017.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 07/03/2017] [Accepted: 07/05/2017] [Indexed: 10/18/2022]
|
16
|
Ntounas P, Katsouli A, Efstathiou V, Pappas D, Chatzimanolis P, Touloumis C, Papageorgiou C, Douzenis A. Comparative study of aggression - Dangerousness on patients with paranoid schizophrenia: Focus on demographic data, PANSS, drug use and aggressiveness. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 60:1-11. [PMID: 30217324 DOI: 10.1016/j.ijlp.2018.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/12/2018] [Accepted: 06/06/2018] [Indexed: 06/08/2023]
Abstract
This cross sectional study aimed to compare the differences in psychopathology of Greek homicide and homicide attempters, patients with schizophrenia, with non violent individuals, suffering from schizophrenia. The study compared three Groups of 220 men, diagnosed with schizophrenia: (a) Group Α (Schizophrenia - No violence, (b) Group Β (Schizophrenia - with violence or violent crime), (c) Group C (Schizophrenia - not guilty by reason of insanity - violent crime). Several psychometric tools were used, such as M.I.N·I (Mini-International Neuropsychiatric Interview), PANSS scale (Positive and Negative Symptoms Scale). Most subjects suffered from paranoid schizophrenia. On factors such as demographic characteristics (i.e. current occupational status, living status), statistically significant findings were shown for Groups B and C vs Group A. Predisposing psychosocial factors, such as family conflicts and aggressiveness against family, were found to be statistically significant in differentiating violent versus nonviolent individuals with psychosis. They differed significantly in factors like history of juvenile delinquency, but also in the type of aggressiveness in general. These differences were confirmed on PANSS scale. In conclusion, the longer the history of aggressiveness is presented, the greater the chances are of individuals falling into Group C and it is possible to spend several years from the onset of the disease until the moment of crime.
Collapse
Affiliation(s)
- Petros Ntounas
- Organization Against Drugs (OKANA), Athens, Greece; 2nd Department of Psychiatry, National and Kapodistrian University of Athens Medical School, "Attikon" General Hospital, Athens, Greece.
| | | | - Vasiliki Efstathiou
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens Medical School, "Attikon" General Hospital, Athens, Greece
| | - Dimitris Pappas
- 5th Psychiatric Department, Psychiatric Hospital of Attica, "Dafni", Athens, Greece
| | | | | | - Charalampos Papageorgiou
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, "Eginition" Hospital, Athens, Greece
| | - Athanassios Douzenis
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens Medical School, "Attikon" General Hospital, Athens, Greece
| |
Collapse
|
17
|
Liem M, van Buuren J, de Roy van Zuijdewijn J, Schönberger H, Bakker E. European Lone Actor Terrorists Versus "Common" Homicide Offenders: An Empirical Analysis. HOMICIDE STUDIES 2018; 22:45-69. [PMID: 30443150 PMCID: PMC6196579 DOI: 10.1177/1088767917736797] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The term "Lone Actor" has been applied to a variety of violent individuals who are thought to act out of ideological motivations using terrorist tactics. So far, much of the research is U.S.-based. There is an empirical vacuum of Lone Actor violence in Europe and a conceptual gap in how these acts may be understood as a variation of homicidal behavior. We examine and compare characteristics of European Lone Actors to European "common" homicide offenders. Lone Actor terrorists constitute a heterogeneous group that is similar to homicide offenders but differs in terms of substance use, weapon use, and target. These findings may be understood in the context of instrumental versus expressive aims.
Collapse
|
18
|
Abstract
SummaryRisk assessment has been widely adopted in mental health settings in the hope of preventing harms such as violence to others and suicide. However, risk assessment in its current form is mainly concerned with the probability of adverse events, and does not address the other component of risk – the extent of the resulting loss. Although assessments of the probability of future harm based on actuarial instruments are generally more accurate than the categorisations made by clinicians, actuarial instruments are of little assistance in clinical decision-making because there is no instrument that can estimate the probability of all the harms associated with mental illness, or estimate the extent of the resulting losses. The inability of instruments to distinguish between the risk of common but less serious harms and comparatively rare catastrophic events is a particular limitation of the value of risk categorisations. We should admit that our ability to assess risk is severely limited, and make clinical decisions in a similar way to those in other areas of medicine – by informed consideration of the potential consequences of treatment and non-treatment.
Collapse
|
19
|
Rozel JS, Mulvey EP. The Link Between Mental Illness and Firearm Violence: Implications for Social Policy and Clinical Practice. Annu Rev Clin Psychol 2017; 13:445-469. [PMID: 28375722 DOI: 10.1146/annurev-clinpsy-021815-093459] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The United States has substantially higher levels of firearm violence than most other developed countries. Firearm violence is a significant and preventable public health crisis. Mental illness is a weak risk factor for violence despite popular misconceptions reflected in the media and policy. That said, mental health professionals play a critical role in assessing their patients for violence risk, counseling about firearm safety, and guiding the creation of rational and evidence-based public policy that can be effective in mitigating violence risk without unnecessarily stigmatizing people with mental illness. This article summarizes existing evidence about the interplay among mental illness, violence, and firearms, with particular attention paid to the role of active symptoms, addiction, victimization, and psychosocial risk factors. The social and legal context of firearm ownership is discussed as a preface to exploring practical, evidence-driven, and behaviorally informed policy recommendations for mitigating firearm violence risk.
Collapse
Affiliation(s)
- John S Rozel
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; ,
| | - Edward P Mulvey
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; ,
| |
Collapse
|
20
|
Pressley T. Public Libraries, Serious Mental Illness, and Homelessness: A Survey of Public Librarians. PUBLIC LIBRARY QUARTERLY 2017. [DOI: 10.1080/01616846.2017.1275772] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
21
|
Zwischenmenschliche Gewalt im Kontext affektiver und psychotischer Störungen. DER NERVENARZT 2015; 87:53-68. [DOI: 10.1007/s00115-015-0040-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
22
|
Abstract
OBJECTIVES Homicide is overwhelmingly committed by men compared to women. Conservative estimates suggest that more than a third of these individuals have a treatable psychiatric disorder. These data present an opportunity to mental health clinicians to assist in the prevention of homicide by improving men's mental health. METHODS We review the current literature on men's mental health with a focus on assessing and reducing homicide risk in men with psychiatric conditions. RESULTS Bipolar disorder and schizophrenia appear to share a neural endophenotype that is a risk factor for homicide. Dual disorders, or the presence of a substance use disorder with other major mental illness, are a major risk factor for homicide in males. Dual diagnosis disorders, personality disorders and pathological traits and male depression share emotion dysregulation, irritability, and reactive aggression. Promoting physician education, addressing firearm safety, reducing the reluctance of men relative to women to engage in help-seeking behaviour, and using targeted risk interviews which integrate these data are all currently recommended. CONCLUSIONS The main focus in prevention of homicidal behaviour in males with psychiatric disorders should be to identify high risk groups, to provide adequate treatment, and to facilitate compliance with long-term treatment while considering male specific problems and needs.
Collapse
Affiliation(s)
- Leo Sher
- Icahn School of Medicine at Mount Sinai , New York , USA
| | | | | |
Collapse
|
23
|
Affiliation(s)
- Eric B Elbogen
- Forensic Psychiatry Program and Clinic, Department of Psychiatry, University of North Carolina-Chapel Hill School of Medicine, CB #7167, Chapel Hill, NC 27599, USA.
| | - Sally C Johnson
- Forensic Psychiatry Program and Clinic, Department of Psychiatry, University of North Carolina-Chapel Hill School of Medicine, CB #7167, Chapel Hill, NC 27599, USA
| |
Collapse
|
24
|
Abstract
INTRODUCTION Cases of folie à deux resulting in homicide challenge traditional definitions of delusions. Secondaries who abandon their beliefs soon after separation from a primary raise doubts about the status of their delusional beliefs at the time of the offence. In this paper, we apply the "two-factor" model of delusions to a series of cases of folie à deux resulting in homicide. METHOD A retrospective analysis of five cases. RESULTS The primary affected person appeared to be the source of the delusional content in each of the cases. Impairment of belief evaluation was evident to some degree in all patients. There appeared to be a range of underlying causes of impaired belief evaluation. The transitory nature of the reported beliefs in some secondary cases suggested that they were due to motivational rather than neuropathological mechanisms. Social isolation contributed to the inability to critically appraise beliefs in most cases. CONCLUSION The two-factor model is a useful method to contrast the emergence of a shared delusional belief in primary and secondary patients with folie à deux. Folie à deux demonstrates the need to consider the exogenous source of delusional content in many patients.
Collapse
Affiliation(s)
- Olav Nielssen
- a Clinical Research Unit for Anxiety and Depression , St. Vincent's Hospital , Sydney , Australia
| | | | | |
Collapse
|
25
|
Golenkov A, Nielssen O, Large M. Systematic review and meta-analysis of homicide recidivism and schizophrenia. BMC Psychiatry 2014; 14:46. [PMID: 24548381 PMCID: PMC3933385 DOI: 10.1186/1471-244x-14-46] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 02/12/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to estimate the proportion of homicide recidivists among population studies of homicide offenders with schizophrenia. METHODS Systematic review and meta-analysis of published studies of homicide associated with schizophrenia conducted in defined populations and indexed in Medline, PsychINFO, or Embase between January 1960 and November 2013. Published data was supplemented with unpublished data about recidivism obtained by personal communication from the authors of published studies of homicide and schizophrenia. Random effects meta-analysis was used to calculate a pooled estimate of the proportion of homicide recidivists. RESULTS Three studies reported that 4.3%, 4.5%, and 10.7% of homicide offenders with schizophrenia had committed an earlier homicide. Unpublished data were obtained from the authors of 11 studies of homicide in schizophrenia published in English between 1980 and 2013. The authors of 2 studies reported a single case of homicide recidivism and the authors of 9 studies reported no cases. The rates of homicide recidivism between studies were highly heterogeneous (I-square = 79). The pooled estimate of the proportion of homicide offenders with schizophrenia who had committed an earlier homicide was 2.3% (95% CI (Confidence Interval) 0.07% to 7.2%), a figure that was not reported in any individual study. The pooled proportion of homicide recidivists from published reports was more than ten times greater (8.6%, 95% CI 5.7%-12.9%) than the pooled proportion of homicide recidivists estimated from data provided by personal communication (0.06%, 95% CI 0.02% to 1.8%). CONCLUSIONS In most jurisdictions, homicide recidivism by people with schizophrenia is less common than published reports have suggested. The reasons for the variation in the rates of homicide recidivism between studies are unclear, although in most jurisdictions long-term secure treatment and supervision after release appears to be effective in preventing homicide recidivism. A prospective study conducted in a large population or in multiple jurisdictions over a long period of time might result in a more accurate estimate the risk of a second homicide by a person with schizophrenia.
Collapse
Affiliation(s)
- Andrei Golenkov
- Psychiatry and Medical Psychology, Chuvash State University, Cheboksary, Russia
| | - Olav Nielssen
- University of New South Wales, Sydney, Australia,Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, Sydney, Australia
| | | |
Collapse
|
26
|
Large M, Golenkov A, Nielssen O. Fear of the (almost) unknown. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2014; 24:1-4. [PMID: 24501076 DOI: 10.1002/cbm.1895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 10/22/2013] [Indexed: 06/03/2023]
Affiliation(s)
- Matthew Large
- Prince of Wales Hospital, Sydney, Australia; University of New South Wales, Sydney, Australia
| | | | | |
Collapse
|
27
|
Large M. The relevance of the early history of probability theory to current risk assessment practices in mental health care. HISTORY OF PSYCHIATRY 2013; 24:427-441. [PMID: 24573753 DOI: 10.1177/0957154x13501275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Probability theory is at the base of modern concepts of risk assessment in mental health. The aim of the current paper is to review the key developments in the early history of probability theory in order to enrich our understanding of current risk assessment practices.
Collapse
Affiliation(s)
- Matthew Large
- Prince of Wales Hospital, and University of New South Wales, Sydney
| |
Collapse
|
28
|
Richard-Devantoy S, Bouyer-Richard AI, Jollant F, Mondoloni A, Voyer M, Senon JL. [Homicide, schizophrenia and substance abuse: a complex interaction]. Rev Epidemiol Sante Publique 2013; 61:339-50. [PMID: 23816066 DOI: 10.1016/j.respe.2013.01.096] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Revised: 01/15/2013] [Accepted: 01/29/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND AIM The prevalence of homicide perpetrators with a diagnosis of schizophrenia is 6% in Western countries populations. The relationship between schizophrenia and homicide is complex and cannot be reduced to a simple causal link. The aim of this systematic review was to clarify the role of substance abuse in the commission of murder in people suffering from schizophrenia. METHODS A systematic English-French Medline and EMBASE literature search of cohort studies, case-control studies and transversal studies published between January 2001 and December 2011 was performed, combining the MeSH terms "schizophrenia", "psychotic disorders", "homicide", "violence", "substance use disorder", and the TIAB term "alcohol". Abstract selection was based on the STROBE and PRISMA checklist for observational studies and systematic and meta-analysis studies, respectively. RESULTS Of the 471 selected studies, eight prospective studies and six systematic reviews and meta-analysis studies met the selection criteria and were included in the final analysis. Homicide committed by a schizophrenic person is associated with socio-demographic (young age, male gender, low socioeconomic status), historical (history of violence against others), contextual (a stressful event in the year prior to the homicide), and clinical risk factors (severe psychotic symptoms, long duration of untreated psychosis, poor adherence to medication). In comparison to the general population, the risk of homicide is increased 8-fold in schizophrenics with a substance abuse disorder (mainly alcohol abuse) and 2-fold in schizophrenics without any comorbidities. A co-diagnosis of substance abuse allows us to divide the violent schizophrenics into "early-starters" and "late-starters" according to the age of onset of their antisocial and violent behavior. The violence of the "early-starters" is unplanned, usually affects an acquaintance and is not necessarily associated with the schizophrenic symptoms. Substance abuse is frequent and plays an important role in the homicide commission. In addition, the risk of reoffending is high. In the "late-starters", the violence is linked to the psychotic symptoms and is directed to a member of the family. The reoffence risk is low and it depends on the pursuit of care or not. CONCLUSION Defining subgroups of violent schizophrenic patients would avoid stigmatization and would help to prevent the risk of homicide by offering a multidisciplinary care which would take into account any substance abuse.
Collapse
Affiliation(s)
- S Richard-Devantoy
- McGill University, Department of Psychiatry & Douglas Mental Health University Institute, McGill Group for Suicide Studies, FBC building, 3rd floor, 6875, boulevard Lassalle, Montréal (Qc), H3W 2N1, Canada.
| | | | | | | | | | | |
Collapse
|
29
|
Abbs B, Achalia RM, Adelufosi AO, Aktener AY, Beveridge NJ, Bhakta SG, Blackman RK, Bora E, Byun MS, Cabanis M, Carrion R, Castellani CA, Chow TJ, Dmitrzak-Weglarz M, Gayer-Anderson C, Gomes FV, Haut K, Hori H, Kantrowitz JT, Kishimoto T, Lee FHF, Lin A, Palaniyappan L, Quan M, Rubio MD, Ruiz de Azúa S, Sahoo S, Strauss GP, Szczepankiewicz A, Thompson AD, Trotta A, Tully LM, Uchida H, Velthorst E, Young JW, O’Shea A, DeLisi LE. The 3rd Schizophrenia International Research Society Conference, 14-18 April 2012, Florence, Italy: summaries of oral sessions. Schizophr Res 2012; 141:e1-e24. [PMID: 22910407 PMCID: PMC3877922 DOI: 10.1016/j.schres.2012.07.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 07/23/2012] [Indexed: 01/30/2023]
Abstract
The 3rd Schizophrenia International Research Society Conference was held in Florence, Italy, April 14-18, 2012 and this year had as its emphasis, "The Globalization of Research". Student travel awardees served as rapporteurs for each oral session and focused their summaries on the most significant findings that emerged and the discussions that followed. The following report is a composite of these summaries. We hope that it will provide an overview for those who were present, but could not participate in all sessions, and those who did not have the opportunity to attend, but who would be interested in an update on current investigations ongoing in the field of schizophrenia research.
Collapse
Affiliation(s)
- Brandon Abbs
- Brigham and Women’s Hospital, Department of Medicine, Connors Center for Women’s Health, Harvard Medical School, Department of Psychiatry, 1620 Tremont Street BC 3-34 Boston, MA 02120, Phone: 617-525-8641, Fax: 617-525-7900
| | - Rashmin M Achalia
- Department of Psychiatry, Government Medical College, Aurangabad, Maharashtra, India. Phone: + 91 9028851672, Fax: + 91 0240 2402418
| | - Adegoke O Adelufosi
- Dbepartment of Psychiatry, Ladoke Akintola University, Teaching Hospital (LAUTECH), Ogbomoso, Oyo State, Nigeria. P.O. Box 2210, Sapon, Abeokuta, Ogun State, Nigeria, Phone: +234 803 5988 054
| | - Ahmet Yiğit Aktener
- Göksun State Hospital, Göksun, Kahramanmaraş, Turkey, Phone: (0090) 532 4465832
| | - Natalie J Beveridge
- School of Biomedical Sciences & Pharmacy, Schizophrenia Research Institute, Room 616 Medical Sciences Building, University of Newcastle, Callaghan NSW 2308, Phone: (02) 4921 8748, Fax: (02) 4921 7903
| | - Savita G Bhakta
- Hofstra-NSLIJHS School of Medicine/The Zucker Hillside Hospital, address: 75 59 263rd street, Glen Oaks, NY-11004, Phone: 718-470-8232, Fax: 718-831-0368
| | - Rachael K Blackman
- University of Minnesota Medical Scientist Training Program (MD/PhD), University of Minnesota Neuroscience Department, and Brain Sciences Center VA Medical Center, Minneapolis, MN, University of Minnesota, Medical Scientist Training Program (MD/PhD), B681 Mayo, 420 Delaware St. SE, Minneapolis, MN 55455, Phone: 612-467-5077
| | - Emre Bora
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, VIC, Australia. Alan Gilbert Building NNF level 3 University of Melbourne, VIC, Australia, Phone: 61 3 8345 5611, Fax: 61 3 8345 5610
| | - MS Byun
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea, address: Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul 110-744, Republic of Korea. Phone: +82-2-2072-2457 Fax: +82-2-747-9063
| | - Maurice Cabanis
- Department of Psychiatry and Psychotherapy, Philipps-University, Rudolf-Bultmann-Straße 8, D-35039 Marburg, Germany, Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Rudolf-Bultmann-Str. 8, D-35039 Marburg, Germany Phone: +49(0)6421-58-66932, Fax: +49(0)6421-58-68939
| | - Ricardo Carrion
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore – Long Island Jewish Health System (NS-LIJHS), Glen Oaks, NY, USA, 2. Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, North Shore – Long Island Jewish Health System, Manhasset, New York, 11030, USA, Phone: 718-470-8878, Fax: 718-470-8131
| | - Christina A Castellani
- Molecular Genetics Unit, Department of Biology, The University of Western Ontario, London, Ontario, Canada, Phone: 519-661-2111 x86928, Fax: 519-661-3935
| | - Tze Jen Chow
- Universiti Tunku Abdul Rahman, Jalan Genting Kelang, Setapak 53300, Kuala Lumpur, Malaysia, Phone: +603-41079802
| | - M Dmitrzak-Weglarz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Szpitalna St. 27/33, Poznan, 60-572, Poland, Phone: +48 618491311, Fax: +48 61484392
| | - Charlotte Gayer-Anderson
- Institute of Psychiatry, King’s College London, De Crespigny Park, London, United Kingdom, SE5 8AF, Phone: 0207 848 5060
| | - Felipe V Gomes
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto/SP 14049-900, Brazil
| | - Kristen Haut
- University of California, Los Angeles, 1285 Franz Hall, University of California, Los Angeles, CA, 90095, Phone: 310-794-9673, Fax: 310-794-9740
| | - Hiroaki Hori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan, Phone: +81 42 341 2711, Fax: +81 42 346 1744
| | - Joshua T Kantrowitz
- New York State Psychiatric Institute/Nathan Kline Institute for Psychiatric Research 1051 Riverside Drive, Room 5807, New York, NY 10023, Phone: 212-543-6711, Fax: 212-543-1350
| | - Taishiro Kishimoto
- (1) The Zucker Hillside Hospital, Psychiatry Research, 75-59 263rd street, Glen Oaks, NY 11004 USA (2) Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, Japan, Phone: +1-718-470-8386, Fax: +718-343-1659
| | - Frankie HF Lee
- 1. Centre for Addiction and Mental Health, 250 College St. Toronto, Ontario, Canada, M5T 1R8, 2. Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada, M5S 1A8, Phone: +1416-535-8501 ext. 4084, Fax: +1416-979-4663
| | - Ashleigh Lin
- School of Psychology, University of Birmingham, Edgbaston, B152TT, United Kingdom, Phone: +44 121 414 6241, Fax: +44 121 414 4897
| | - Lena Palaniyappan
- Translational Neuroimaging, Division of Psychiatry, University of Nottingham address: C09, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, Phone: 01157430407, Fax: 01157430422
| | - Meina Quan
- 1. Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, 1249 Boylston Street, Boston, MA, 02215. 2. Laboratory of Neuroscience, Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, 940 Belmont Street, Brockton, MA, 02301, Phone: 617-525-6264, Fax: 617-525-6150
| | - Maria D Rubio
- University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, 1719 6th Ave S Rm 590, Birmingham, AL 35233, Phone: 205-996-6229
| | - Sonia Ruiz de Azúa
- CIBERSAM (Biomedical Research Center in Mental Health Net), University Hospital of Alava, University of the Basque Country, 29 Olaguibel St., 01004, Vitoria, Spain. Phone: 0034 945007664, Fax: 0034 945007664
| | - Saddichha Sahoo
- Clinical Fellow, Dept of Psychiatry, University of British Columbia, Vancouver, BC, Canada V6T1Z3
| | - Gregory P Strauss
- Department of Psychiatry, University of Maryland School of Medicine, Maryland Psychiatric Research Center, P.O. Box 21247, Baltimore, MD 21228, Phone: (410) 402-6104, Fax: (410) 402-7198
| | - Aleksandra Szczepankiewicz
- Laboratory of Molecular and Cell Biology, Department of Psychiatric Genetics, Poznan University of Medical Sciences, 27/33 Szpitalna St., 60-572 Poznan, Poland, Phone: +48-618491311, Fax: +48-61-8480111
| | - Andrew D Thompson
- Orygen Youth Health Research Centre, 35 Poplar Rd, Parkville, VIC 3052, Australia Phone: +61 3 93422800, Fax: +61 3 9342 2941
| | - Antonella Trotta
- Psychosis Studies, Institute of Psychiatry, King’s College London, United Kingdom, PO52 Psychosis Studies, Institute of Psychiatry, King’s College London, De Crespigny Park, London SE5 8AF, United Kingdom, Phone: +44 (0)743 5214863, Fax: +44 (0)20 7848 0287
| | - Laura M Tully
- Harvard University, Address: 33 Kirkland St., Cambridge MA 02138, Phone: 857-207-5509
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo, 160-8582, Japan, Phone: +81.3.3353.1211(x62454), Fax: +81.3.5379.0187
| | - Eva Velthorst
- Academic Medical Center, Department of Early Psychosis, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands, Phone: +31 (0)20 89 13671, Fax: +31 (0)20 89 13635
| | - Jared W Young
- University of California San Diego, Department of Psychiatry, 9500 Gilman Drive, La Jolla, CA, 92093-0804, Phone: 619 543 3582, Fax: 619 543 2493
| | - Anne O’Shea
- Coordinator of reports. Harvard Medical School, VA Boston Healthcare System, 940 Belmont Street, Brockton, MA 02301, Phone: 774-826-1374
| | - Lynn E. DeLisi
- Corresponding Author, VA Boston Healthcare System and Harvard Medical School, 940 Belmont Street, Brockton, MA 02301, Phone: 774-826-1355, Fax: 774-826-1758, Address all correspondence to Lynn E DeLisi, MD,
| |
Collapse
|
30
|
Ahn BH, Kim JH, Oh S, Choi SS, Ahn SH, Kim SB. Clinical features of parricide in patients with schizophrenia. Aust N Z J Psychiatry 2012; 46:621-9. [PMID: 22441206 DOI: 10.1177/0004867412442499] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
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.
Collapse
Affiliation(s)
- Byoung-Hoon Ahn
- Department of Psychiatry, National Institute of Forensic Psychiatry, Ministry of Justice, Gongju, Korea
| | | | | | | | | | | |
Collapse
|
31
|
Abstract
BACKGROUND Mania has been reported to be a risk factor for aggression and violence in psychiatric hospitals, but the extent of any association between mania and severe interpersonal violence in community settings is not known. AIM To examine the association between mania and severe violence in a series of patients found not guilty by reason of mental illness (NGMI). METHODS A review of the court documents of those found NGMI of offences involving severe violence, including homicide, attempted homicide and assault causing wounding or serious injury, in New South Wales between 1992 and 2008. RESULTS Twelve of 272 people found NGMI were in a manic state when they committed a severe violence offence. Ten were diagnosed with schizo-affective disorder and two with bipolar disorder. Three patients were in the depressed phase of schizo-affective disorder and there were no patients in the depressed phase of bipolar disorder. CONCLUSION Mania, in particular the manic phase of bipolar disorder, is not strongly associated with severe violence.
Collapse
Affiliation(s)
- Olav B Nielssen
- 1Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Darlinghurst, Sydney, Australia
| | | | | |
Collapse
|
32
|
Golenkov A, Large M, Nielssen O, Tsymbalova A. Characteristics of homicide offenders with Schizophrenia from the Russian Federation. Schizophr Res 2011; 133:232-7. [PMID: 21821396 DOI: 10.1016/j.schres.2011.07.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Revised: 07/06/2011] [Accepted: 07/10/2011] [Indexed: 11/15/2022]
Abstract
BACKGROUND It has been suggested that the characteristics of homicides committed by people with schizophrenia from regions with a high total homicide rate differ from the characteristics of homicides by people with schizophrenia from regions with low rates of homicide. METHODS Homicide offenders in the Chuvash Republic of the Russian Federation have been systematically examined for over 30 years. This study reports on a review of the documents from pre-trial psychiatric assessments and legal proceedings of all people charged with homicide offenses between 1981 and 2010 who were found to have schizophrenia. FINDINGS There were 133 people (120 men, 13 women) with an ICD-10 diagnosis of schizophrenia who committed a homicide offense in the 30 years of the study, including 15 repeat homicide offenders and 9 homicides with multiple victims. The odds ratio (OR) for homicide associated with schizophrenia was 13.5, 95% confidence interval (CI) (11.4-16.0). The mean age of the offenders was 34.8 (SD 9.6) and most had the paranoid subtype of schizophrenia (78%). The majority of victims were family members (51%) or acquaintances (43%). Delusions of persecution, auditory hallucinations and other positive symptoms were present in 58% of offenders at the time of the homicide. The remaining 42% exhibited negative symptoms such as emotional deficits, had antisocial attitudes or were regarded as having impaired self-control. Alcohol intoxication was reported at the time of 45% of homicides. Stabbing was the most common method and few of the homicides involved firearms. CONCLUSION The characteristics of homicide offenders with schizophrenia from Chuvashia do not appear to differ greatly from those of homicide offenders with schizophrenia from regions with far lower rates of homicide.
Collapse
|
33
|
Magliano L, Read J, Marassi R. Metaphoric and non-metaphoric use of the term "schizophrenia" in Italian newspapers. Soc Psychiatry Psychiatr Epidemiol 2011; 46:1019-25. [PMID: 20640568 DOI: 10.1007/s00127-010-0274-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 07/06/2010] [Indexed: 11/30/2022]
Abstract
PURPOSE This study examines how the term "schizophrenia" is used in Italian newspapers. METHODS The survey was carried out on the 22 Italian newspapers which allow word scanning on their online website. In each newspaper, the terms "schizophrenia" and "schizophrenic" were scanned in all articles, from January 1, 2008 to December 31, 2008. Each article containing these terms was analyzed in relation to metaphorical usage to describe or denigrate people or groups not diagnosed "schizophrenic" and in relation to non-metaphoric, direct descriptions of people using mental health services, or the illness itself. RESULTS "Schizophrenia/schizophrenic" was reported in 1,087 articles. It was used far more frequently as a metaphor (73.7%) than in reference to people actually given the diagnosis (19.2%) or to the disorder itself (7.1%). The 801 metaphoric uses were classified into the following categories: incoherence/contradiction/split (682, 85.1%), dangerousness/aggressiveness (34, 4.4%), and eccentricity/oddness (84, 10.5%). 117 out of 209 (55.9%) articles on people diagnosed with the disorder were in news section of which 57 (48.7%) referred to homicides, 17 (14.5%) to other assaults by the person, and 33 (28.2%) to assaults directed at the person. CONCLUSIONS These data confirm previous studies showing that the media disproportionately report negative stories about people diagnosed with "schizophrenia", and in particular, equate the diagnosis with violence. The study also demonstrates that the metaphorical use of the term to denigrate groups or individuals may be an equal or greater contributor to the stigma and prejudice experienced by people with this mental disorder.
Collapse
Affiliation(s)
- Lorenza Magliano
- Department of Experimental Medicine, Second University of Naples, Naples, Italy.
| | | | | |
Collapse
|
34
|
Affiliation(s)
| | - William T. Carpenter
- To whom correspondence should be addressed; tel: 410-402-7101, fax: 410-788-3837, e-mail:
| |
Collapse
|