[Characteristics of Schizophrenia Patients' Homicide Behaviors and Their Correlations with Criminal Capacity].
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Abstract:
To explore the characteristics of schizophrenia patients' homicide behaviors and the influences of the assessments of criminal capacity.Indicators such as demographic and clinical data, characteristics of criminal behaviors and criminal capacity from the suspects whom were diagnosed by forensic psychiatry as schizophrenia （n=110） and normal mental （n=70） with homicide behavior, were collected by self-made investigation form and compared. The influences of the assessments of criminal capacity on the suspects diagnosed as schizophrenia were also analyzed using logistic regression analysis.There were no significant statistical differences between the schizophrenic group and the normal mental group concerning age, gender, education and marital status （P>0.05）. There were significant statistical differences between the two groups concerning thought disorder, emotion state and social function before crime （P<0.05） and there were significant statistical differences in some characteristics of the case such as aggressive history （P<0.05）, cue, trigger, plan, criminal incentives, object of crime, circumstance cognition and self-protection （P<0.05）. Multivariate logistic regression analysis suggested that thought disorder, emotion state, social function, criminal incentives, plan and self-protection before crime of the schizophrenic group were positively correlated with the criminal capacity （P<0.05）.The relevant influences of psychopathology and crime characteristics should be considered comprehensively for improving the accuracy of the criminal capacity evaluation on the suspects diagnosed as schizophrenia with homicide behavior.Keywords:
Homicide
Forensic psychiatry
Marital status
This study aimed to investigate the factors associated with parricide in patients with schizophrenia who committed homicide.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.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.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.
Homicide
Forensic psychiatry
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Objective To study the extent of delay in help-seeking and its related factors among patients with schizophrenia in rural communities.Methods Twenty-three villages were sampled from Liuyang City using stratified-cluster random sampling techniques.Clues of schizophrenia were identified among 61 165 residents,in which 220 persons were diagnosed as schizophrenia by using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders-Patient Edition (SCID-I/P).Delay of help-seeking was defined as being delayed 60 days and more to visit a doctor after psychiatric symptoms was notified.Results Among 220 cases with schizophrenia,only 71 (32.3% ) visited doctors within one month after psychiatric symptoms notified,129(58.6% ),113(51.4% ),and 104(47.3% ) delayed at least two,three and six months,respectively.Subtle onset,negative symptoms (such as apathy,hypobulia),lower-level educated, unstable marital and family structure were major risk factors of delay in help seeking Conclusion Delay in help-seeking in patients with schizophrenia is a serious mental health problem in rural areas.This study implies that targeted health education and scanning for schizophrenia are urgently needed to promote patients with schizophrenia seeking help from medical institutions.
Key words:
Rural health; Schizophrenia; Office visits; Delay of help-seeking
Apathy
Marital status
Stratified Sampling
Help Seeking
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Introduction Parricide (referring as parental homicide) is a rare event among homicides, yet challenging and intriguing from psychiatric point of view. Still, literature concerning parricide is sparse and most studies concern small or heterogenous samples or anecdotal cases. Objective To analyze differences in parricide offenders among forensic psychiatric inpatients at the university psychiatric hospital Vrapče's centre for forensic psychiatry. Aims To test some differences between parricide offenders with regard to specific type of parricide. Methods Available retrograde data of 50 years forensic inpatients ( n = 430). We identified parricide cases of matricide and patricide included. Results The analysis included a total of 22 parricide offenders. All parricide offenders were male adults. Matricide was more prevalent then patricide (13 vs. 9). Matricide offenders were in average younger when committed crime, had more prevalence of psychotic disorders and earlier onset of symptoms in comparison with patricide group. Conclusion We identified differences and similarities between these two parricide offenders groups. It is important to expand research further including different types of motives and family dynamics regarding the type of parricide victim. Disclosure of interest The authors have not supplied their declaration of competing interest.
Homicide
Forensic psychiatry
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It is well known from several international studies that the incidence rates for schizophrenia, based on first-admission samples, are low in Denmark, especially in females, compared with other countries. This might be due to special diagnostic traditions in Denmark. To analyze how Danish psychiatrists reach a diagnosis of schizophrenia, a stratified subsample of 122 cases out of all 1,259 patients, aged between 12 and 64 years, with a first hospital admission in 1976 under the diagnosis of schizophrenia, paranoid psychosis, acute reactive paranoid psychosis, or casus limitaris was selected. For this subsample, psychopathological symptoms, as documented in the clinical case-notes, were rated by PSE-9 symptom lists for subsequent CATEGO analysis. The core syndrome of schizophrenia, as defined by the CATEGO class S+, showed no association with the clinical schizophrenia diagnosis compared with the other diagnoses mentioned. Also, positive symptoms of schizophrenia did not determine the diagnosis, but for typical negative symptoms such associations were indicated. Some negative symptoms also seemed to be linked to a depressive state. Furthermore, the present work indicates that using first-admission data leads to a higher age at schizophrenia onset and a lower first-admission rate in Denmark compared with Germany.
Danish
Diagnosis of schizophrenia
Paranoid schizophrenia
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Schizophrenia is a chronic mental disorder that leads to disability in several aspects of the individual's personal, social, and occupational functioning. This study assesses and compares the level of disability among Nigerian outpatients with schizophrenia and healthy controls (HC). A comparative cross-sectional study among 100 schizophrenia outpatients with an ICD-10 diagnosis and 100 HC was conducted over a 4-month period. They completed a questionnaire containing the Zung's Self-Rating Depression Scale (SDS), the World Health Organization Disability Assessment Schedule-Second Version (WHODAS-II). Symptoms of schizophrenia were assessed with the Positive and Negative Syndrome Scale (PANSS). Student's t tests and Chi-square were used to compare patient with schizophrenia and healthy control. Pearson correlation and multiple linear regression analyses were used to assess the relationships of socio-demographic and clinical variable with disability. The patients with schizophrenia reported greater disability than the HC on most of the disability domains of WHODAS-II. They also reported significantly higher mean Zung's SDS scores than the HC. Depressive symptoms, negative symptoms, and PANSS total were significantly related to all the WHODAS-II domains. The disability summary score was significantly predicted by depressive symptoms, negative and positive symptoms of schizophrenia, number of active symptoms (relapse) of schizophrenia, and marital status [F (5, 94) = 23.90, p < 0.001]. Schizophrenia is a disabling disorder that affects different aspects of a patient's life. Treatment strategies that target these different aspects may help in reducing disability.
Marital status
Diagnosis of schizophrenia
Depression
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The chronic and debilitating nature of schizophrenia creates a disease with marked clinical and economic consequences. Among patients with schizophrenia the prevalence of smoking is significantly higher than in the general populace. Smoking in schizophrenia appears to be associated with increased psychopathology and disability. However, there is a dearth of Nigerian studies attempting to determine the effects of smoking on clinical outcome among patients with schizophrenia. Understanding the effects of smoking on the severity of disability and psychopathology in schizophrenia would help us to plan appropriate psychosocial interventions for these patients To determine if comorbid smoking in schizophrenia is associated with increased disability and psychopathology. To determine the difference in the severity of disability and psychopathology among smokers and non smokers with schizophrenia. To determine the association between dosage of antipsychotics prescribed and disability among smokers and non smokers with schizophrenia. A cross-sectional descriptive study in which 367 out patients with ICD 10 diagnosis of schizophrenia were recruited. Socio-demographic questionnaire, Present State Examination Schizophrenia and Tobacco sections, Positive And Negative Syndrome Scale and World Health Organization Disability Assessment Schedules were administered. Current smoking was associated with increased disability (t=2.32, p<0.02) among the participants studied. The results of this study indicate that smoking in Nigerian schizophrenia patients is associated with significant disability. Effective measures to promote smoking cessation in schizophrenia should be implemented in Nigerian patients.
Diagnosis of schizophrenia
Cross-sectional study
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We describe, thirteen psychopathologic dynamics based on defense mechanism and primary process thinking, that could determined an homicide committed by a patient with schizophrenia. The purpose of this study is to allow: a) to improve diagnosis of the homicidal act; b) to emphasize psychopathological elements which can be treated by specific forensic psychotherapy; c) to prevent an homicidal recidivism through evaluation of risk passing to the homicidal act.
Homicide
Recidivism
Forensic psychiatry
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A total of 1018 and 812 first degree relatives (FDR) of schizoprencies and controls respectively, were studied to find out the psychiatric morbidity in the families of paranoid and non-paranoid schizophrenia patients. The risk of schizophrenia and affective disorders was found to be independent of the probands subtype diagnosis. The risk for schizoid-schizotypal and paranoid personality disorders was found to be increased in the first degree relatives of paranoid schizophrenic, as compared to non-paranoid schizophrenic, thus suggesting that the psychopathology in the FDR may differ with the subtype diagnosis of the proband.
Paranoid schizophrenia
Proband
First-degree relatives
Paranoid Disorders
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