Homicide offending and its main determinants in patients with schizophrenia or bipolar mood disorders

Abstract

SummaryAims: This study aimed to assess the prevalence of homicide in patients suffering from schizophrenia or bipolar mood disorders and determine the main underlying determinants of this violent behavior. Method:In a retrospective study, we reviewed the characteristics of 600 consecutive patients hospitalized at Farabi Hospital in Kermanshah, Iran with the main diagnosis of schizophrenia (n=300) or bipolar mood disorders (n=300).. The diagnosis was made based on the psychiatric report and the DSM-IV criteria. Study information was collected by reviewing hospital record files.Results: In our sample 13.3% of patients with schizophrenia and 20.0% of those with bipolar mood disorders committed homicide. In both groups, more than two-thirds of offenders were male and more than half were younger than 30 years. In patients with schizophrenia the main triggers of homicide were delusional beliefs (50.0%) followed by auditory hallucinations (50.0%). In bipolar mood disorders the main triggers of homicide included paranoid delusional beliefs (73.3%), excitement, irritability and impulsive behavior (20.0%), and auditory hallucinations (6.6%). Conclusions:A notable proportion of patients with schizophrenia or bipolar mood disorders in Iran commit homicide. Homicide is considerably more prevalent in men, in younger patients, and in those with delusional beliefs. homicide, schizophrenia, bipolar mood disordersThe relationship between violent behaviors and mental disorders is now taken into consideration by specialists in behavioral science and psychiatric disorders. Homicide is a type of aggressive behavior that may be triggered by different motivations [1]. Several factors are involved in the increased occurrence of homicide, such as socioeconomic pressures, cultural factors and literacy [2]. In fact, violence occurs when the balance between internal impulses and the individual's control systems is impaired. The most common predictor factors include a history of violence, access to means of coercion, loss of controlling anger, history of previous convictions, history of homicide, loss of parents, and chronic hostility or hatred [3]. In this context, the presence of psychiatric disorders is of particular importance [4]. In psychiatric patients, the majority of violent acts are due to the nature of their underlying illness, such as

Homicide in Relation to Mental Illness: Stigma Versus Reality

“…Homicides associated with mental disorders were more prevalent in men than in women. Additionally, almost half of the offenders’ ages ranged between 18 and 35 in Wales and England, while more than half were younger than 30 years of age [ 18 , 19 ].…”

“…In a retrospective study conducted in Iran, 20% of 600 hospitalized patients committed homicide. Of those, 20% were found to have bipolar disorders [ 19 ]. The manic phase of bipolar disorders was linked to a higher rate of violent offenses than the depressive phase (45.3% vs. 6.9%) in South Korea.…”

Trend Analysis of Homicide Mortality and Years of Life Lost in the South of Iran, 2004-2019

“…4 Several factors play a role in increasing the incidence of homicide, including socio-economic pressures, cultural factors, and literacy. 5 In 1996, the World Health Assembly (1996) called for violence research to be promoted as a public health research priority. 6 In 2015, it was estimated that 51 000 adolescents globally died from homicide, which was far more than the number of adolescent deaths from armed conflict (30 000), including war and internal unrest 7 .…”