精神分裂症患者凶杀行为特征的对比研究

目的探讨精神分裂症凶杀行为特征.方法用自编犯罪学调查表,分别对60例精神分裂症行凶者与30例精神正常的行凶者进行对照分析.结果精神分裂症患者凶杀行为发生的平均年龄大于精神正常者,作案前多数无预谋,无准备,无合伙,常有先兆,其作案动机以报复为主;对照组则以贪利、激情杀人多见.精神分裂症患者杀害对象以妻子、子女、邻居为主,实施作案方式常于白天、在自己家、公开实施作案,案发后不潜逃.结论两组在年龄、个性特征、行为动机、作案方式、杀害对象、案发后表现的显著性差异是评定精神分裂症患者辨认能力和自我控制能力的主要依据.     

精神分裂症患者凶杀行为临床分析

目的：探讨精神分裂症患者凶杀行为的犯罪学和临床特点。方法：采用自编犯罪学调查表对215例精神分裂症行凶者进行统计分析。结果：以杀人致死为主，被害对象多为配偶和父母，常发生于3，4，5月份，白天，自己家中。病程在3年以内略多，以偏执型、有被害妄想、未住院治疗者较多。结论：精神分裂症患者凶杀行为后果严重，凶杀对象主要是与患者密切接触者。     

精神病患者与精神正常者凶杀行为的对比研究

为探讨精神病患者与精神正常者凶杀作案行为的异同点，对９２例精神病患者与８３例精神正常者的杀人行为进行了对比研究。结果：在作案时的年龄、大量杀人、杀害对象、作案场所、是否合伙作案、作案有无动机、作案前有无准备和作案后有无自杀行为等方面，精神病患者与精神正常者有显著性差异，此差异与发生精神病的年龄、疾病症状、病理变化等特点有关。结果还显示，如果作案者为女性、单独作案、凶杀对象是关系亲密的亲人，常常是由精神病患者所为。     

精神疾病患者凶杀犯罪学特征

目的：探讨凶杀精神疾病患者犯罪学特征及相关因素。方法：对167例凶杀精神疾病患者和158例非凶杀精神疾病患者进行对照分析。结果：凶杀行为的发生与心理社会因素、负性生活事件、社会支持低、家庭经济状况差及未得到及时治疗、病期长等因素有关。精神疾病患者作案时常无预谋、无隐蔽性,杀害对象以亲人为主,作案后缺乏自我保护性。结论：给予精神疾病患者社会支持,及时就医,进行心理干预,减少凶杀行为的发生。     

43例司法精神医学鉴定为精神分裂症的凶杀案例分析

目的探讨司法精神医学鉴定诊断为精神分裂症凶杀作案行为及作案后表现的特点。方法对43例司法精神医学鉴定中被诊断为精神分裂症的凶杀案例资料进行回顾性分析。结果精神分裂症占凶杀案例鉴定为有精神障碍总数的43%；被鉴定人作案先兆、动机、预谋、作案方式、作案后表现均有一定的特点。结论精神病理因素影响精神分裂症作案后的表现，综合分析作案行为及作案后的表现，有助于精神分裂症患者凶杀行为的辨认、控制能力评定。     

精神分裂症患者凶杀行为特征分析

目的：探讨精神分裂症凶杀行为特征。方法：用自编行为特征调查表，分别对83例精神分裂症行凶与62例精神正常行凶进行对照分析，并对前的精神症状特点进行分析。结果：精神分裂症行凶性格以内向及多疑为主，而精神正常行凶性格以外向及暴躁为主，精神分裂症行凶其作案目的不明或受病态支配为主，精神正常作案目的以贪利及激情作案为主，精神分裂症患多于白天在自己家中公开作案，伤害时象以家人为主，精神正常以伤害同事为主，精神分裂症患作案后多数不潜逃、不销毁工具，其作案工具以菜刀及身边物件为主。精神分裂症行凶其精神症状以被害妄想及幻听为主。其伤害的家人主要是妻子及母亲，大部分在起病3年内作案。结论：两组在个性特点、行为动机、作案方式、伤害时象、案发后表现及作案工具方面有显差异，可以作为评定辨认能力及控制能力的重要因素。为减少精神分裂症凶杀行为的发生，应尽量加强刚起病3年内的看护及治疗。     

57例涉嫌暴力犯罪精神障碍患者的犯罪特征分析

目的探讨近十年纳入上海市刑事侦查总队的57例涉嫌暴力犯罪精神障碍患者的犯罪特征。方法采用自编调查表,对符合入组标准57例的犯罪学特征、人口学资料及疾病诊断资料进行收集与分析。结果男性多于女性,非婚状态多于在婚状态,初中及以下学历者多于高中及以上学历者,40岁及以下者多于40岁以上者,城市户籍多于农村户籍。37例定性为暴力犯罪,临时起意者多于有预谋者,且作案多无现实动机,暴力主要指向家人及熟人,且手段残暴者多见,同时又有近三分之一的暴力犯罪者将暴力指向自身。病种以精神分裂症居首,抑郁症或严重抑郁情绪者其次,应激相关障碍第三。结论精神障碍患者暴力犯罪具有无预谋性,突发及不可预测性,受疾病症状影响缺乏现实动机,自控力明显减弱,家人及熟人易成为其暴力指向对象,作案手段凶狠残暴,有慈悲杀人及过剩杀人、杀人后自杀现实。病种以精神分裂症居首,其次为抑郁症,再者为应激障碍,精神症状中以幻觉、妄想、抑郁、焦虑、易激惹危害为大。     

精神分裂症伤害案的对比研究

目的　探讨精神分裂症患者和精神正常者伤害案的差异。方法　用自制犯罪行为特征调查表对精神分裂症患者和精神正常者各 80例的伤害行为进行对比研究。结果　在伤害致死、伤害对象、作案场所和作案后有无自杀和自首行为等方面 ,两组有显著差异。研究组大多数受幻觉 ,忘想支配下作案 ( 88 6 % ) ,致死率高 ( 4 3 8% ) ,作案对象多为亲属 ( 37 5% ) ,多在家中或在晚上作案 ,少有自首行为。结论　精神分裂症患者伤害案的犯罪特征明显异于正常人 ,此差异与患者病理心理特征有关     

不同类型抑郁障碍患者作案特征的比较

目的 探讨不同类型抑郁障碍患者作案特征。方法 对云南省精神病医院于1980－2000年鉴定的37例抑郁症（抑郁症组）和31例抑郁障碍组[包括15例心因（反应）性抑郁症、9例抑郁性神经症、7例其他类型抑郁障碍]的作案特征进行对照研究。结果 抑郁症组作案行为发生突然、随机性强（占62％）,缺乏诱因（占76％）,病理性动机作案多见（占54％）,并多以凶杀和伤害案为主（占76％）,侵害对象主要涉及家庭成员（占54％）;作案后自杀未隧及主动求死者较多（占38％）。抑郁障碍组作案多有诱因（占55％）、作案后逃离现场（占45％）,事后为其行为作辩解（占38％）、并要求宽大（占34％）。两组比较,差异有显著性（P＜0．05）。结论 抑郁症组和抑郁障碍组在作案特征上有各自不同的特点,可能与两者的起病（病因）、病情发展、症状表现和严重程度等差异有关。     

有凶杀行为的男性精神分裂症患者染色体研究

目的：研究凶杀行为与染色体的关系。方法：对有凶杀行为的男性精神分裂症患者（研究组）和无凶杀行为的男性精神分裂症患者（对照组）进行染色体对照研究。结果：染色体数目与结构畸变率差异无显著性（P＞0．05）。对Y、E和F组的相对长度测量发现，研究组有14例Y／F指数大于1．0，Y／F平均指数0．91，具有长Y染色体，其频率为19．44％。对照组无1例具有Y染色体者，Y／F平均指数小于1．0。两组比较差异均有显著性（P＜0．01）。结论：有凶杀行为的精神分裂症患者有长Y倾向，提示对有长Y染色体的患者更应采取预防措施，以防止其暴力行为的发生。     

Mentally abnormal homicide in New Zealand as defined by legal and clinical criteria: a national study

BACKGROUND: Homicides by people with mental illness have been studied using either clinical or legal categorization of the homicide as abnormal. No previous study has employed both definitions in the same population. METHOD: A retrospective study of all homicides in New Zealand between 1988 and 2000 considered mentally abnormal homicide using a legal definition (when the courts deemed a contribution of mental illness was present) and a clinical definition (defined as the presence of a discharge diagnosis from inpatient mental health treatment) of 'mentally abnormal'. Rates, characteristics and time trends were investigated. RESULTS: Of the 844 cases, 7.1% met legal criteria for being mentally abnormal, while 7.7% had ever received a diagnosis for a psychotic illness, and a further 14.5% had been admitted to a psychiatric hospital for any other reason. The majority (60%) of perpetrators with a psychotic diagnosis received a mental health disposition from the court. Of these, 60% were first diagnosed with their psychotic illness prior to the homicide, while 28% were first diagnosed at the time of the offence and a further 12% after imprisonment. Of all those who received a psychotic diagnosis, 89% had post-conviction admissions or a mental health disposition. CONCLUSION: Legal and clinical definitions of mentally abnormal homicide detect similar rates of mentally abnormal homicide, but illustrate somewhat different dimensions of the relationship between mental illness and homicide.     

Psychiatric aspects of homicide

Homicide is frequently associated with mental illness and suicide. The present study is an investigation of all known homicide incidents in Iceland during the past 80 years (1900–1979). There were 45 homicide incidents, involving 52 victims and 47 offenders. One-third of the perpetrators were either psychotic, mentally subnormal, or committed suicide. A further one-third were diagnosed as personality disordered, alcoholic, drug dependent or neurotic. A substantial proportion of the offenders suffered from fairly marked physical disabilities, and the mentally ill were significantly more frequently afflicted by such defects. Over 60 % of the offenders and 50 % of the victims were under the influence of alcohol at the material time. The findings are generally consistent with those of previous psychiatric studies of homicide.     

Victimisation and the Insanity Defence: Coping with Confusion,Conflict and Conciliation

According to long-established legal tradition the mentally ill who commit serious offences, such as homicide, have in most jurisdictions available to them the exculpatory defence of insanity. A successful insanity plea typically results in an acquittal in regard to any index crime(s), and indeterminate detention or supervision until the mentally ill person is no longer deemed to be a threat to themselves or the community. For those who experience victimisation in circumstances where a successful insanity defence is subsequently raised, the outcome can be especially traumatic. Many victims remain confused and perplexed by the proceedings, while others express anger and resentment about such a verdict, perceiving it to be unjust and a barrier to any healing process, including restorative justice. In this article, based on a series of case studies drawn from mental health tribunal hearings in an Australian jurisdiction, an analysis is made of the varying responses and special needs of victims involved in insanity acquittals, and of possible measures to better manage victimisation issues in such settings.     

Homicide of Strangers by People with a Psychotic Illness

Background: The homicide of strangers by people with psychosis, referred to here as “stranger homicides,” are rare and tragic events that generate adverse publicity for mental health services and have resulted in significant changes in mental health policy and law. Aim: To estimate the incidence of stranger homicides, using data from previously published studies, and to compare the characteristics of psychotic offenders who killed strangers with the characteristics of those who killed a close relative. Method: Meta-analysis of the population-based studies of homicide by persons suffering from a psychosis in which the number of subjects who killed strangers was also reported. Characteristics of stranger homicide and family homicide offenders were examined in a multicenter case–control study of homicide during psychotic illness in four high-income countries. Results: A pooled estimate of 1 stranger homicide per 14.3 million people per year (95% confidence interval, 1 in 18.9 million to 1 in 11.5 million people per year) was calculated by meta-analysis of 7 studies. The characteristics of the 42 stranger homicide offenders from New South Wales [NSW], Quebec and Eastern Ontario, Finland, and the Netherlands were identified. Twenty seven (64%) of these had never previously received treatment with antipsychotic medication. The stranger homicide offenders were more likely to be homeless, have exhibited antisocial conduct, and had fewer negative symptoms than those who killed family members. The victims of stranger homicide were mostly adult males and the homicides rarely occurred in the victim’s home or workplace. Conclusions: Stranger homicide in psychosis is extremely rare and is even rarer for a patient who has received treatment with antipsychotic medication. A lack of distinguishing characteristics of stranger homicide offenders and an extremely low base rate of stranger-homicide suggests that risk assessment of patients known to have a psychotic illness will be of little assistance in the prevention of stranger homicides.     

Homicide and psychosis: criminological particularities of schizophrenics, paranoiacs and melancholic. A review of 27 expertises

INTRODUCTION: During the night of the 11 to 12 of December 2002, Mathieu X. 21 years old, convinced he was defending himself from evil human beings decapitated a nurse and an auxiliary nurse of the psychiatrist hospital. This crime, which received saturated media coverage, obviously raises questions about the dangerous and violent nature of the mentally ill, which can sometimes culminate in homicide. Firmly rooted in the collective consciousness is the popular idea that someone who kills an unknown person in the street is mentally ill. Conversely, the epidemiological data are reassuring; only 15% of such crimes are committed by the seriously mentally ill (schizophrenia, paranoia, melancholia). AIM: Typing and comparison of homicides committed by schizophrenic, paranoiac and melancholic persons. METHOD: Several murders committed by psychotic persons are presented in this article. This retrospective study shows several types of pathological murder (schizophrenia, paranoiac delirious disorder, affective disorder: melancholia and hypomania). Twenty-seven cases have been selected and analysed from 268 cases prepared over 30 years by two psychiatrists, whose diagnoses were schizophrenia, paranoia, melancholia or hypomania. RESULTS: From these 268 cases of homicide examined, 27 murderers were psychotic. Ten of these were young, single, jobless, male schizophrenics: they drank little alcohol. Most of them had a criminal history. They were paranoid schizophrenics whose hallucinatory mechanisms fed mostly persecuted, sexual and metaphysical themes. Forty percent of them were disorganised, and half of them showed negative features. They knew their victim (family, friends). Nine others were paranoiac, for the most part male, older, married, family men, without psychiatric or criminal record. Intuitions with delirious fed persecuted (77%), jealous (40%) or prejudicial themes. They murdered their wife or husband or neighbour. Alcohol consumption was often involved. Schizophrenic and paranoiac murderers often have an emotional temper. Conversely, melancholic murderers are mostly female aged around 30, married, family women, drinking little alcohol. Two-thirds of them have psychiatric records of depression, bipolar disorders and attempted suicide. Altruism is the most frequent delirious theme. Their murders are more often premeditated. They know the victim: child or partner. Suicide often follows the murder.     

Homicide in the Canadian Prairies: elderly and nonelderly killings.

OBJECTIVE: To examine the psychosocial and clinical characteristics of male perpetrators of elderly and nonelderly homicides in the Canadian Prairies. METHOD: We examined data drawn from a study of 901 adult homicide offenders who were incarcerated or on parole between 1988 and 1992 in Alberta, Saskatchewan, and Manitoba. RESULTS: Of those studied, 67 men were convicted of homicide involving 79 elderly victims, and 671 were convicted of homicide involving 675 nonelderly victims. Most perpetrators were single and engaged in irregular patterns of employment at the time of their index offence. Fourteen (20.8%) offenders with elderly victims had a history of psychiatric treatment, compared with 98 (14.6%) offenders with nonelderly victims; however, this difference was not statistically significant. Approximately 30% of both groups were diagnosed with personality disorders. A comparison of the index- offence characteristics showed no significant differences between the 2 groups. CONCLUSION: Our findings suggest that elderly individuals are more likely to be killed in their own homes by strangers. Social isolation appears to be a significant risk factor in cases of elderly homicide.     

A psychiatric and social matched case series comparison of victims of criminal homicide and homicide perpetrators in Sweden

The aim of the present study was to compare the psychosocial profiles of criminal homicide victims with those of a matched sample of perpetrators. The hypothesis was that chance determines whether someone becomes a victim or a perpetrator. In a retrospective examination of forensic psychiatric records as well as hospital records, the following variables were studied: nationality, education, substance abuse and psychiatric diagnoses. A comparative study was performed of 88 perpetrators and 83 victims in Sweden during a time period of 17 years (1978-1994). All subjects had been treated as psychiatric inpatients before the homicide. The results support the hypothesis that perpetrators and victims of homicide are similar with regard to psychiatric morbidity and social functioning. The majority were born in Sweden, and the educational level was low in both groups. Substance abuse was common in both groups: 96.7% of male and 65.3% of female victims compared with 76.6% of male and 75% of female perpetrators. Many in both of the groups had criminal records. The only major difference between the groups was recorded for psychotic disorder diagnoses, with a higher rate among perpetrators as well as a lower rate of substance abuse in this group.     

Serum testosterone levels, mental disorders and criminal behaviour.

OBJECTIVE: Although previous studies have revealed an association between androgens and aggression, there is a lack of knowledge of this issue in different mental disorders. METHOD: The associations between serum testosterone levels and criminal behaviour in different mental disorders were examined using data collected from forensic psychiatric male patients (20 schizophrenics and 42 subjects with personality disorders). RESULTS: Male criminals with personality disorders had significantly higher serum levels of total and free testosterone than criminal schizophrenics. Among schizophrenics, total (P=0.01) and free testosterone (P=0.01) declined significantly more with age compared to healthy controls and patients with personality disorders, and also correlated with duration of neuroleptic drug use (r=-0.60, P=0.000 for total and r=-0.46, P=0.0001 for free testosterone). The recidivists with personality disorder had higher total (P=0.04) and free testosterone (P=0.05) levels than non-recidivists with personality disorder. CONCLUSION: Personality disordered criminals with multiple offences had high serum testosterone levels. The low testosterone concentrations among schizophrenics may be due either to long-term use of neuroleptic agents or to the mental illness itself and its possible inhibition of the pituitary-gonadal axis.