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