Biopsychosocial and forensic clinical correlates of schizophrenia and homicide.

摘要

The present study sought to examine a subtype of homicidal schizophrenic individuals, and to elucidate biological and psychosocial differences between these schizophrenic murderers and their non-schizophrenic and non-murdering counterparts. Participants were recruited from a medical university brain hospital in Nanjing, China, and grouped according to psychiatric diagnosis and homicide conviction: normal controls (n = 47), schizophrenic non-murderers (n = 33), non-schizophrenic murderers ( n = 31), schizophrenic murderers (n = 32), and homicide psychiatric controls (n = 14). All were assessed in areas of intellectual and executive functioning, resting EEG, current psychosocial functioning and childhood psychosocial deprivation, and forensic clinical homicide factors. Results indicated that schizophrenic murderers---along with all other schizophrenia and homicide groups---demonstrated reduced Verbal, Performance, and IQ performance relative to normal controls, while some evidence for increased executive functioning in schizophrenic murderers compared to schizophrenic non-murderers and non-schizophrenic murderers was suggested. Also, while schizophrenic non-murderers were characterized by increased diffuse slow-wave EEG activity compared to all other groups, schizophrenic murderers were not and instead demonstrated increased left-hemispheric fast-wave activity relative to schizophrenic non-murderers. Additionally, group differences in current psychosocial functioning were also detected, and schizophrenic murderers reported abnormally elevated levels of childhood psychosocial deprivation; and were characterized by higher birth order than non-schizophrenic and non-murderer counterparts. Furthermore, the homicides of schizophrenic murderers appeared distinct from other types of murderers in various motivational, behavioral, and emotional aspects. Results are discussed within the framework of a proposed biopsychosocial interactional trajectory toward violence in schizophrenia---perhaps stemming from paternal germ line mutations, and involving left hemispheric hyperarousal deficits in interactions with early psychosocial deprivation and specific psychosocial stressors---which may lead to a homicidally violent schizophrenic outcome. Ultimately, results suggest further evidence for a biopsychosocially distinct subgroup of schizophrenic murderers, which could have implications in research, treatment, forensic applications, and social perception.