Homicidal Act Commited by an Elderly Person With Sexual Dysfunction. Case Report

Abstract

Sexual dysfunctions (SDs) are highly prevalent with aging. Studies reported an interactive correlation between psychiatric morbidity and SD. Also, SDs have significant influence on patients` self-esteem, body image, interpersonal relationships, and physical health in general. The aim of the present research is to present an intimate partner homicide case and to discuss a possible correlation between SDs of elderly patients and their inclination towards aggressive behavior from intimate partner violence (IPV). A forensic psychiatric assessment was performed on a married male patient, aged 61. He was diagnosed and treated for BPH and he could no longer have sexual intercourse. Using a knife, he provoked over 20 stab wounds to his wife, who died following the attack. He admitted that he was jealous, due to his wife having an affair. The psychiatric forensic expertise found that the killing was committed with discernment. Psychological states found in IPV perpetrators are partly like those met in SDs patients. The relation between SDs in older adults and aggressive behavior, especially IPV, requires further research. In the case discussed, a complex of negative emotions and aggressiveness could be determined equally by infidelity of the spouse or by the perpetrator’s SD, but we can assume that SD played a relevant role in the causal chain.

Violence and delusional jealousy in Parkinson’s disease

“…It has also been suggested that an imbalance between dopamine and norepinephrine may affect the forebrain and hypothalamic response to stress which may lead to abnormal behaviours and delusions although this theory has not been thoroughly researched to date 15. Finally, sexual dysfunction is common in PD and this has been associated with delusions of infidelity20 and intimate partner violence 21…”

“…[15] Finally, sexual dysfunction is common in Parkinson's disease and this has been associated with delusions of infidelity [20] and intimate partner violence. [21] The psychosis improves in most patients with the withdrawal of dopamine agonists and treatment with antipsychotic medications such as quetiapine or clozapine. Clozapine is often favoured as it causes less deterioration in motor symptoms, [22] and the associated sedation can be beneficial by reducing behavioural symptoms at night.…”