Background: Intimate partner homicide (IPH) is a global public health problem. One study conducted over 66 countries found that 13.5% of all homicides and 38.6% of female homicides were committed by an intimate partner. In South Africa, there were no published studies that examine alleged perpetrators of IPH that were referred for forensic psychiatric observation.Aim: To describe the profile of accused persons referred for forensic psychiatric observation for a charge of murder or attempted murder of their intimate partners. Certain characteristics were further examined according to the psychiatric observation outcomes.Setting: The study was conducted at Sterkfontein Hospital, a forensic psychiatric hospital in Gauteng, South Africa.Methods: A retrospective record review of accused persons referred for forensic psychiatric observation for a charge of murder or attempted murder of their intimate partners was conducted. The period of the review was 19 years. The definition of intimate partners included current or former spouses and partners, same-sex partners and rejected suitors.Results: One hundred and sixty-three files, which included forensic psychiatric reports, were reviewed. The findings related to the profile of accused persons and offence characteristics indicated that: (1) history of violent behaviour is prevalent; (2) homicides mostly occur in private homes; (3) knives and firearms are most often used; (4) infidelity, separation and jealousy are common motives; (5) psychotic disorders, personality disorders and substance use disorders feature prominently. A total of 88% of the sample were found fit to stand trial and 82% were found criminally responsible. Factors significantly associated with being found fit to stand trial and criminally responsible following the forensic psychiatric observation were: male gender, having received a tertiary education, employment prior to the offence, earning a salary of more than R10 000, having no previous psychiatric or medical illness, a positive forensic history, previous intimate partner violence (IPV) perpetration, indicating a motive for the homicide, having no psychiatric illness at the time of the offence which would impact fitness to stand trial and criminal responsibility.Factors significantly associated with being found not fit to stand trial and not criminally responsible following the forensic psychiatric observation were: female gender, having received a primary education, unemployment prior to the offence, having a previous psychiatric or medical illness, no forensic history, no previous IPV perpetration, not indicating a motive for the homicide, having a psychiatric illness at the time of the offence which would impact fitness to stand trial and criminal responsibility.Conclusion: The characteristics highlighted in this study can contribute to the development of risk assessment tools which can be used to identify likely perpetrators of IPH. Other interventions, for example controlling access to knives and firearms, reducing substance abuse and improving mental health services, are also important in the prevention of IPH.

The DSM-[ ], which should be published in , will in all likelihood have a category named Neurodevelopmental Disorders, under which "DHD will resort. This shift in nosology lays the foundation of the argument that will be put forward in this chapter, therefore the following points need to be emphasised and warrants further discussion. Firstly, this categorisation is based on shared aetiology, rather than shared symptoms or shared developmental stage as was the case with the DSM-IV-TR . Historically, disorders were classified according to shared aetiology as was the case with DSMI and DSM-II , as opposed to shared symptomatology as was the case with DSM-III and DSM-IVTR . The DSM-is to a greater, or lesser, extent a combination of these as it proposes a change to the categorisation, but not the symptoms of this disorder.The second point is that the shared aetiology is a neurobiological based aetiology. The name of the category implies that these disorders have a common, underlying, neurobiological cause. The question which arises is to what extent these disorders do have an underlying neurobiological cause, to what extent this is shared, and even to what extent these causes are shared within the sub-categories of disorders, for example "DHD. Grouping these disorders together implies a relatively homogenous group of disorders, and even further that the subcategories are homogenous within themselves. The DSM-makes provision for sub-categories of "DHD, i.e. the Combined, Predominantly Inattentive, Inattentive Restrictive and predominantly Hyperactive/ Impulsive, presentations. Does the grouping of these sub-categories necessarily imply that they share the same neurobiological aetiology? The argument that will be put forward in this chapter is that although they all share a neurobiological cause, this cause is not common and that the sub-categories may have subtle or gross, differences in these neurobiological factors.

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