Psychotic homicides in Copenhagen from 1959–1983
Clinic of Forensic Psychiatry, Ministry of Justice, Institute of Theoretical Statistics, Copenhagen, Denmark. Acta Psychiatrica Scandinavica
(Impact Factor: 5.61).
10/1987; 76(3):285-92. DOI: 10.1111/j.1600-0447.1987.tb02897.x
During the years from 1959 to 1983, 263 Copenhagen defendants of homicide underwent a psychiatric examination for the court. Twenty-three percent of the defendants were held to be psychotic at the time of the crime. The psychotic defendants differed from the non-psychotic by being older, less often substance abusing and by choosing victims inside their families. It is discussed whether a reduction in the available number of psychiatric beds could be a contributional reason for the increase in especially the number of schizophrenic defendants. About one third of all defendants were by the examining psychiatrists found in need of a sanction different from ordinary punishment; furthermore, a tendency towards sanctions of treatment instead of just placement in a psychiatric hospital was documented and is discussed. The increasing demand of capacity for forensic, psychiatric patients is mentioned.
Available from: Fabrice Jollant
- "De même, plusieurs méta-analyses impliquent plusieurs fois les mêmes données. Les e ´tudes d'Appleby et al. , Erb et al., 2001 , Hafner et Boker , Hafner et Boker , Laajasalo et al., 2006  figurent dans les méta-analyses de Nielssen et al.   et Large et al.  , l'article de Gottlieb et al., 1987  figure dans la méta-analyse de Nielssen et al.  et Large et al.  et enfin, l'e ´tude de Nielssen et al., 2007  figure dans les méta-analyses de de Nielssen et al.   et de Fazel et al. . Troisièmement, chaque e ´tude définit ses propres critères d'inclusion, comprenant le type de population e ´tudiée (détenus, patients hospitalisés, patients ambulatoires), le type d'e ´tude (transversale, cohorte. . "
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ABSTRACT: 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.
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.
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.
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.
Revue d Épidémiologie et de Santé Publique 06/2013; 61(4). DOI:10.1016/j.respe.2013.01.096 · 0.59 Impact Factor
Available from: T. H. Pham
- "The data as a whole suggest that mental illness precedes homicide (Côté & Hodgins, 1992; Gottlieb et al., 1987; Schanda et al., 2004; Côté & Hodgins, 2003). In the study by Joyal et al. (2004), a large majority of the homicides was considered to be consequent to psychotic symptoms. "
Acta psychiatrica Belgica 01/2013; 133(2):39-46.
Available from: Christian C Joyal
- "However, the vast majority were known by their offender, either at a personal or professional level, and they were generally assaulted in a private home. These results confirm previous reports suggesting that strangers are less likely to be the target of psychotic violent offenders than known persons, such as friends, acquaintances, health care providers or relatives (Gottlieb et al. 1987; Straznickas et al. 1993 ; Estroff et al. 1998; Taylor & Gunn, 1999), and that offences usually take place in a residence (Steadman et al. 1998). "
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ABSTRACT: While men with schizophrenia are at higher risk of displaying homicidal behaviours compared with the general population, very little is known about the circumstances related to the triggering of such violent acts among offenders with schizophrenia. The main goal of the present investigation was to describe the surrounding context, psychotic symptoms, target characteristics and other circumstantial factors associated with homicidal acts committed by men with schizophrenia, with or without an additional antisocial personality disorder (APD).
Comprehensive clinical and research interviews, as well as multiple sources of information including reports from social workers and police officers, criminal records, witness statements and questionnaires completed by friends, acquaintances and family members were used to determine specific characteristics surrounding the homicidal acts.
Overall, a significant majority of homicides were considered as the consequence of psychotic symptoms; they mostly involved someone who knew the offender; and they usually occurred in a private residence. However, the subgroup of offenders with both schizophrenia and APD were less likely to be judged as responding to psychotic symptoms; they assaulted a non-relative more frequently, and they were more likely to have used alcohol and to be involved in an altercation with the victim prior to the incident than offenders without APD.
Even for such extreme acts as homicides, the circumstances affecting the occurrence of violence among offenders with schizophrenia may differ when an additional APD diagnosis is present, which would have important implications for prevention and treatment programmes.
Psychological Medicine 05/2004; 34(3):433-42. DOI:10.1017/S0033291703001077 · 5.94 Impact Factor
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