Results
The final sample thus consisted of 28 female patients accused of criminal offenses involving violent behavior. All the patients agreed to participate in the study. Table 1 shows the sample’s sociodemographic data. The most common psychiatric diagnosis was schizophrenia (n=13; 46%) (Table 2). Table 2 also lists other clinical variables such as history of psychiatric follow-up, use of psychoactive medication, or alcohol or psychoactive substance user prior to the offense. Homicide or attempted homicide (n=14; 50%) was the most common type of violent behavior (Table 2). Homicide per se had been committed by 11 patients (39%), with the following diagnoses: schizophrenia/schizoaffective disorder (n=5), mental retardation (n=2), bipolar disorder (n=1), borderline personality disorder (n=1), epilepsy (n=1), and no mental disorder (n=1). The latter patient was admitted by court order (accused of murdering her husband), although she did not present any mental disorder.
Nearly half of the victims (n=14; 47%) were family members of the patients. The principal means for perpetrating the act were cold steel weapons (n=9; 32%). Some 21% (n=6) of the patients had a prior history of aggressive behavior. As for criminal responsibility for the act, the majority of the patients (n=24; 86%) were considered not responsible on grounds of insanity.
According to the initial forensic psychiatric assessment (Forensic Mental Health Report), 14 patients (50%) out of the total sample (n=28) presented psychotic symptoms at the time of the assessment. The most common psychotic symptoms were auditory hallucinations (n=8 cases) and persecutory delusions (n=6 cases). One patient also presented disorganized thinking. Of the two patients with epilepsy, one presented psychotic disorder and the other mood disorder resulting from their clinical condition.
Five (18%) of the 28 patients had committed filicide or attempted filicide (killing or attempting to kill their own children). Three presented diagnosis of schizophrenia/schizoaffective disorder, one mental retardation, and another borderline personality disorder. Seven children in all had suffered such aggression, and one patient had tried to kill her three children by throwing them into a river (all three survived). Two of the seven children died. The children’s age ranged from one to seven years. Both of the children that died were one to two years old. Five of the children were boys and two were girls. As for the method used, three children suffered attempted drowning, one was struck on the head with a blunt object, one was burned, one was poisoned, and one was thrown off the high floor of a building. The latter two died. In all the cases, the patients were the children’s principal caregivers. Only one case involved a history of the child’s prior physical abuse. The two women convicted of killing their children had a history of prior suicide attempts and alcohol abuse.