Homicidal Behaviour in Elderly Patients Admitted to a Psychiatric Hospital

Abstract

Fourteen elderly psychiatric patients who attempted or committed homicide are described. Most were cognitively impaired. None were intoxicated despite many having histories of alcohol abuse. Few patients went to court, had a history of domestic violence or previous psychiatric treatment. The sole patient to complete homicide was the only patient who used a gun. None had attempted suicide. The frequency of neuropsychiatric symptomatology highlights the need for psychiatric assessment of elderly offenders.

Caractérisation clinique et criminologique des meurtriers âgés présentant une démence

“…Les études réalisées auprès de sujets incarcérés [1] et de patients hospitalisés dans des hôpitaux psychiatriques [25], éventuellement sécuritaires [22,23], suggèrent que certains facteurs de risque de violence chez les personnes âgées sont This page was created using Nitro PDF trial software.…”

“…tableau 1), dont l'intensité était légère [24] à sévère [3,24]. Dans ce dernier cas, la persécution délirante intervient dans la genèse du meurtre quand le persécuteur est accessible [12,25]. Chez les sujets âgés, et a fortiori déments, la persécution délirante serait un facteur de risque de violence plus important que l'abus de toxiques [19].…”

Violence in older people with mental illness

“…In studies conducted in in-patient units and nursing homes, refusal of services was the most frequent precipitant of assault by patients with functional and organic illnesses (Ticehurst 1992;Almvik 2006): having a bath or shower was thought to have precipitated nearly a fifth of assaults. Greater impairment in activities of daily living has been associated with increased risk of physical aggression towards staff in patients with Alzheimer's disease, even after adjusting for severity of dementia (Lyketsos 1999).…”

“…Males greatly outnumbered females in a study of older people with mental illness who had attempted or carried out homicide (Ticehurst 1992).…”

“…In an Australian study, just over a third of elderly psychiatric patients charged with attempted or actual homicide had comorbid physical illness, nearly half had significant hearing impairment and a fifth had significant impairment of vision (Ticehurst 1992).…”