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Most Parricides Linked to Psychotic Illness

Although untreated psychosis seems to underlie a number of cases of parricide, there can be other causes as well—for example, severe depression, the desire for wealth, or the wish to end a parent's pain.

Fortunately children rarely kill their parents. But because parricide is so uncommon, it is hard for researchers to gather a large enough sample of cases to better understand the circumstances surrounding it and the possible reasons.

However, Dominique Bourget, M.D., an associate professor of psychiatry at the University of Ottawa in Canada, and coworkers managed to gather one of the largest samples of parricides to date—64 cases. The information they gleaned from this sample, obtained by searching coroners' files in Quebec between 1990 and 2005, was published in the September Journal of the American Academy of Psychiatry and the Law.

The murders were committed by children ranging in age from 14 to 58 years, with an average age of 31 years. Most of the murders were committed by sons, not daughters.

Fifty-eight percent of the victims were fathers and 42 percent mothers. Most of the murders occurred in the family home. Also, the child was usually living in the family home at the time of the murder. In fact, four children had only recently moved back to their family home after separation from their spouses.

A number of the murders were extremely brutal. In eight instances, the victims' bodies were decapitated or mutilated, particularly their genitals.

Some two-thirds of the cases appeared to be due to active symptoms of psychosis or severe depression. "Overall, the most common cause of parricide was psychosis with a diagnosis of schizophrenia," Bourget and his coworkers wrote. For example, two offenders had Capgras syndrome and believed that their parents had been replaced by imposters. Other studies have also found that individuals with this syndrome are prone to violence or parricide.

Still other factors, such as substance abuse, anger, or the desire for monetary gain, seemed to explain the remaining cases. About a third of the offenders who were intoxicated at the time of murder were also psychotic.

There were only four cases of females murdering their parents. Two—a teen and a woman in her 30s—gave evidence of psychosis at the time of the murder. The third, a woman in her 30s, was severely intoxicated. The fourth, a woman in her 50s, had a diagnosis of depression and had attempted suicide.

Also of note: three cases out of the whole sample involved the killing of an elderly ailing parent in which the causes seemed to be extreme depression compounded by distress over the pain experienced by the ill parent.

Yet even with these insights, questions about parricide press for answers. Most crucially, can parricide be prevented?

Most of the victims did not seem to have any idea that their children were a danger to them. However, a few of the killers did apparently give warning signs, such as behavioral disorganization or a worsening of psychotic symptoms. And in such cases, parents may be able to do something to protect themselves, Bourget and his colleagues suggested.

For example, when an actively psychotic child threatens to kill a parent, the parent should not underestimate the risk, Bourget and his coworkers stressed. "We examined several cases," they wrote, "in which the parent minimized the risk despite overt threats to his life."

Psychiatrists may be able to help prevent parricide in cases in which the perpetrator is already under psychiatric care, Jeffrey Metzner, M.D., a clinical professor of psychiatry at the University of Colorado and a former chair of the APA Council on Psychiatry and Law, told Psychiatric News. For instance, if patients with schizophrenia are reluctant to take medication and view their parents with hostility, their psychiatrists should perform risk assessments on them and perhaps involve their parents in the risk assessments as well.

However, it is often difficult to prevent parricide because of deficiencies in the mental health care system, Metzner admitted.

"Cases of parricide often expose significant system issues in either the state department of social services from a child-protection perspective (in the case of adolescent parricide) and in the community mental health care system (in the case of adult parricide)."

The situation is similar in Canada, Bourget said. "Access to the mental health system is more and more difficult, and first-line workers often do not have the necessary training or knowledge to recognize the severity of the risk. For instance, I recall this one very unfortunate case where the mother was told by a social worker that she must be 'overreacting.' [In a few other cases, the children] were taken to the emergency department, but were not felt to be in need of hospitalization."

The study was funded by the Quebec Coroner's Office, the University of Ottawa, and the University of Sherbrooke.

An abstract of "Parricide: A Comparative Study of Matricide Versus Patricide" is posted at <www.jaapl.org/cgi/content/abstract/35/3/306>.

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