정신분열병 환자에서 존속살인의 임상적 특성
Clinical Features of Parricide in Patients with Schizophrenia
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Objectives：This study aimed to describe the demographic, clinical and offense characteristics of the patients with schizophrenia who committed parricide. This study also investigated the risk factors of parricide by comparing with characteristics of stranger killers to prevent the tragic offense. Methods：The sample consisted of 88 schizophrenic patients who committed homicide, 59 of them committed parricide and 29 of them killed strangers. Medical chart review regarding demographic and clinical characteristics as well as offense characteristics was conducted. The information that was difficult to be obtained through chart review was acquired by direct interview. Results：Parricide group had earlier age of onset, more conflicts with the victims, more violence history toward victims and more offense provoking events than stranger killing group. Parricide group showed higher rate of past treatment than that of stranger killing group. However drug compliance at the time of offense was low in both groups. Offense provoking events in the parricide group included blaming, threatening a forced hospitalization or medication toward patients. The most common psychiatric symptoms associated with homicide were threat/control override (TCO) symptoms, delusional perception, commanding auditory hallucination and especially with parricide, Capgras syndrome (CS). Conclusion：Interaction between psychotic symptoms such as TCO, CS and underlying emotion toward victims are likely to be associated with parricide. Mental health professionals are expected to play an important role in preventing this tragic offense by active history taking of the violence and effective management with active caregiver education/intervention of intrafamilial conflicts. (J Korean Neuropsychiatr Assoc 2008;47(4):334-340)
Abstract
Objectives：This study aimed to describe the demographic, clinical and offense characteristics of the patients with schizophrenia who committed parricide. This study also investigated the risk factors of parricide by comparing with characteristics of stranger killers to prevent the tragic offense. Methods：The sample consisted of 88 schizophrenic patients who committed homicide, 59 of them committed parricide and 29 of them killed strangers. Medical chart review regarding demographic and clinical characteristics as well as offense characteristics was conducted. The information that was difficult to be obtained through chart review was acquired by direct interview. Results：Parricide group had earlier age of onset, more conflicts with the victims, more violence history toward victims and more offense provoking events than stranger killing group. Parricide group showed higher rate of past treatment than that of stranger killing group. However drug compliance at the time of offense was low in both groups. Offense provoking events in the parricide group included blaming, threatening a forced hospitalization or medication toward patients. The most common psychiatric symptoms associated with homicide were threat/control override (TCO) symptoms, delusional perception, commanding auditory hallucination and especially with parricide, Capgras syndrome (CS). Conclusion：Interaction between psychotic symptoms such as TCO, CS and underlying emotion toward victims are likely to be associated with parricide. Mental health professionals are expected to play an important role in preventing this tragic offense by active history taking of the violence and effective management with active caregiver education/intervention of intrafamilial conflicts. (J Korean Neuropsychiatr Assoc 2008;47(4):334-340)
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