."A violência é, em primeiro lugar, os outros". Alain Teyresite INTRODUÇÃO "Existe um meio de libertar os homens da maldição da guerra?", Einstein surpreende Freud na famosa troca de correspondência entre os dois gênios. A resposta é rápida: "em princípio, os conflitos de interesse entre os homens são solucionados mediante o uso da força". Explica Freud que a evolução tecnológica e intelectual pode e, muitas vezes, está a serviço de estimular o poder pelas armas ou pelo conhecimento. O objetivo seguiria sendo o mesmo, aniquilar o outro. O respeito ao inimigo vem da necessidade de utilizar a vítima para seus propósitos, bastando mantê-la subjugada e atemorizada. Essas são reflexões que seguem atuais, escritas sob a égide da Segunda Guerra Mundial. Partindo do "filicídio institucionalizado" representado pelos conflitos mundiais, conclui-se que as aflições dos grandes mestres sobre as tendências autodestrutivas da humanidade resistem, apesar dos reiterados esforços da sociedade em explicá-las e evitá-las.Partindo da experiência em estudar e acompanhar vítimas e perpetradores de violên-cia, na experiência diária como psiquiatras forenses, membros do judiciário, médicos que atendem a realidade dos ambulatórios e dos centros de triagem, estudiosos de urbanismo e outros determinantes sociais, os autores agruparam suas experiências e conhecimentos para refletir e propor alternativas para lidar com um dos ângulos mais cruéis do crime, aquele que atinge os mais fracos por limitações físicas, emocionais ou sociais. Foi realizada pesquisa bibliográfica recente, ampla e atual, buscando contemplar os diferentes vértices do tema. O enfoque multidisciplinar é, já, uma das propostas. O problema da violência intrafamiliar e do-
Homicides followed by the offender's suicide are rare, and their prevalence ranges from 1% to 1.5% in the United States and in the United Kingdom 1 . There are not prevalence studies of this kind in Brazil. Such type of violence may occur in intimate partner homicide (uxoricide), children homicide (filicide), or multiple family members' homicide (familicide). Killing spouse and children is the most common form of familicide 2 , which has steadily grown in the United States 3 . In order to analyze these types of crimes researchers frequently turn to newspapers, or assess survivors' files in forensic psychiatric hospitals 1,2,4 .Familicide offenders are mainly males and victims are mainly females and children. The most common instrument of commitment is the use of firearms owned by the offender, whose following suicide is frequently committed with the use of firearm, by self-hanging, or by medicine overdose 1,2,5 .Familicides are mainly males, older, highly educated, likely to show depressive symptoms during the year prior to the homicide commitment, frequently use of firearms, and are more harmful when compared to filicides 2,6 .When compared to uxoricides, familicides are more likely to be married, less likely to previous offensive behavior, and more prone to commit suicide after the offence 2,7 .Familicides are frequently depressives, narcissistic and dependent personality traits are outstanding among survivors 2 .Studies show that familicide offenders are mainly raised by loss of control over the family, fear of abandonment, narcissistic rage, job loss, long-term unemployment, and inability to support the family 1,2,8 .It is common the alleged altruistic behavior in order to protect family members from catastrophic outcome.The case reported is of a 41 years old man, born and resident in Rio Grande do Sul State countryside, farmer, unfinished basic education, no previous criminal records, assessed for criminal liability evaluation after the attempted murder of his wife and son followed by suicide attempt, at the Mauricio Cardoso Forensic Psychiatric Institute, in Porto Alegre, Brazil.Three years before the offense, the defendant was diagnosed as depressed with history of two suicide attempt. He was then hospitalized and undergo to community treatment afterwards. The
Our results demonstrate the efficiency of the new primary health care approach.
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