Dear Editor,
I wish to bring for your attention the case of S.L.R., single, male, retired and inmate of the Complexo Hospitalar do Juquery. Accord- ing to the police, the patient (48 years) struck iron shots to the head of his father (73 years) who was sleeping and caused his death. He would have discussed with the victim who asked the son to leave the house and not having accepted such request he decided to kill him. The defendant reported that on the day of the crime, his head was “a thousand degrees”, he heard voices of his father and neighbors, he thought that people wanted to kill him, a woman would have voodoo to kill his father, he couldn’t sleep, he was agitated and without re- ceiving haloperidol decanoato injection for four years. According to reports from his family members, the patient’s father was psychotic and violent. There are many relatives who suffer from mental illness and others committed homicides. The patient is coming from the countryside and with unfinished basic education. He was engaged twice for a few years. One of the his women was assaulted often by him, once he threw her from a ravine and she fractured her skull. He had the habit of killing animals. He changed his behavior at age 25 after his mother’s death. He became aggressive and began to have hallucinations, incoherent thought and persecutory delusions. He was admitted to the psychiatric hospitals and he followed treatment outpatient irregularly. The patient lived with his father for more than ten years, the relationship was bad, they attacked each other and he always talked about killing his father. The patient violently assaulted his father a year before the murder. Some days before the murder, father and son were fighting, the patient was seen with er- ratic behavior, disorganized speech, delusions, hallucinations and repeatedly said he wanted “blood and kill”. After the murder the patient told a neighbor: “I killed that damn old man and still turned on the light to see if he was dead”. Then he said he wanted to kill his neighbours and killed a dog. He was found by a brother-in-law and he said that he wished to kill the whole family. He was captured by the police in a bus station in a near town, he was quiet and wait- ing his brother arrives. At the present, the patient occasionally has periods of intensification of productive symptoms with homicide and suicidal ideation even hospitalized and in regular use of depot antipsychotic. Currently the patient reveals mannerisms, residual persecutory delusions and inappropriate affect. He meets diagnostic criteria for Paranoid Schizophrenia.
Parental homicide or parricide is defined as murder of the fa- ther or the mother or any
other legitimate ascendant and patricide is defined as murder of the father (predominantly
committed by sons). It is a rare crime, represents 2%-3% of homicides in general and 20% to
30% of psychotic murders11 Bourget D, Gagné P, Labelle ME. Parricide: a comparative study of matricide
versus patricide. J Am Acad Psychiatry Law. 2007;35:306-12.,22 Dakhlaoul, Khémiri, Gaha N, Ridha R, Haffani F. Psychotic parricide:
clinical and analytic study about 16 cases. La Tunisie Medicale. 2009;87
(12):824-8.,44 Devaux C, Petit G, Perol Y, Porot M. Poll sur le parricide en France. Ann
Med Psychol. 1974;1(2):161-8.. The relationship between mental illness and violence has been
controversial, for some authors schizophrenia is associated with an increased risk of violence
while other authors claim that this mental illness must not be considered dangerous11 Bourget D, Gagné P, Labelle ME. Parricide: a comparative study of matricide
versus patricide. J Am Acad Psychiatry Law. 2007;35:306-12.
2 Dakhlaoul, Khémiri, Gaha N, Ridha R, Haffani F. Psychotic parricide:
clinical and analytic study about 16 cases. La Tunisie Medicale. 2009;87
(12):824-8.-33 Cornic F, Olié JP. Le parricide psychotique. La prevention en question. L’
Encéphale. 2006;32:452-8.. Several studies show that the subtype paranoid schizo- phrenia,
persecutory delusions, auditory hallucinations, a history of violent acts, the association of
use of alcohol or drugs and stopping the use of antipsychotic medication or absence of
treatment increase the risk of violent behavior11 Bourget D, Gagné P, Labelle ME. Parricide: a comparative study of matricide
versus patricide. J Am Acad Psychiatry Law. 2007;35:306-12.
2 Dakhlaoul, Khémiri, Gaha N, Ridha R, Haffani F. Psychotic parricide:
clinical and analytic study about 16 cases. La Tunisie Medicale. 2009;87
(12):824-8.
3 Cornic F, Olié JP. Le parricide psychotique. La prevention en question. L’
Encéphale. 2006;32:452-8.
4 Devaux C, Petit G, Perol Y, Porot M. Poll sur le parricide en France. Ann
Med Psychol. 1974;1(2):161-8.-55 Malmquist CP. Schizophrenia, delusional disorders, and the prediction
problem regarding homicides. In: Homicide the psychiatric perspective. Washington DC:
American Psychiatric Press Inc. 1996. p. 81-108.. The case
reported is congruent with the literature described.
The most common diagnosis among the patricides is schizo- phrenia and a review of the
literature reveals that such offenders are usually male, young, unmarried, unemployed, living
with his father in the countryside, have low education and low socio-economic level. The
victim is usually dead in his bedroom and the attacker using sharp objects11 Bourget D, Gagné P, Labelle ME. Parricide: a comparative study of matricide
versus patricide. J Am Acad Psychiatry Law. 2007;35:306-12.
2 Dakhlaoul, Khémiri, Gaha N, Ridha R, Haffani F. Psychotic parricide:
clinical and analytic study about 16 cases. La Tunisie Medicale. 2009;87
(12):824-8.
3 Cornic F, Olié JP. Le parricide psychotique. La prevention en question. L’
Encéphale. 2006;32:452-8.-44 Devaux C, Petit G, Perol Y, Porot M. Poll sur le parricide en France. Ann
Med Psychol. 1974;1(2):161-8..
These crimes are not premeditated and can be precipitated by some misunderstanding, are
brutal and abrupt, with affective indif- ference and often caused by persecutory delusions and
command auditory hallucinations. Classically has been described an apparent “calming” the
murderer after the crime and about half of them at- tempted suicide after the act11 Bourget D, Gagné P, Labelle ME. Parricide: a comparative study of matricide
versus patricide. J Am Acad Psychiatry Law. 2007;35:306-12.
2 Dakhlaoul, Khémiri, Gaha N, Ridha R, Haffani F. Psychotic parricide:
clinical and analytic study about 16 cases. La Tunisie Medicale. 2009;87
(12):824-8.
3 Cornic F, Olié JP. Le parricide psychotique. La prevention en question. L’
Encéphale. 2006;32:452-8.-44 Devaux C, Petit G, Perol Y, Porot M. Poll sur le parricide en France. Ann
Med Psychol. 1974;1(2):161-8.. The crime reported shows similarity to the revision of several
authors and it can be concluded that adherence to psychiatric treatment, continuous use of
antipsychotic medication (preferably in the form depot in cases of little cooperation), con-
stant supervision of their acts, family support and hospitalization if necessary are actions
more effective in reducing violent behavior or homicide among people who suffer from
schizophrenia.
References
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1Bourget D, Gagné P, Labelle ME. Parricide: a comparative study of matricide versus patricide. J Am Acad Psychiatry Law. 2007;35:306-12.
-
2Dakhlaoul, Khémiri, Gaha N, Ridha R, Haffani F. Psychotic parricide: clinical and analytic study about 16 cases. La Tunisie Medicale. 2009;87 (12):824-8.
-
3Cornic F, Olié JP. Le parricide psychotique. La prevention en question. L’ Encéphale. 2006;32:452-8.
-
4Devaux C, Petit G, Perol Y, Porot M. Poll sur le parricide en France. Ann Med Psychol. 1974;1(2):161-8.
-
5Malmquist CP. Schizophrenia, delusional disorders, and the prediction problem regarding homicides. In: Homicide the psychiatric perspective. Washington DC: American Psychiatric Press Inc. 1996. p. 81-108.
Publication Dates
-
Publication in this collection
2014
History
-
Received
10 Aug 2014 -
Accepted
23 Sept 2014