Bagcilar Education And Research Hospital Department of Psychiatry, Istanbul, Turkey.
Compr Psychiatry. 2010 Mar-Apr;51(2):135-41. doi: 10.1016/j.comppsych.2009.03.006. Epub 2009 Apr 22.
In this study, we aimed to describe the social and clinical characteristics and offense details in a sample of people with schizophrenia convicted of homicide in the eastern region of Turkey. This study was performed in Elazig Mental Hospital between November 2004 and May 2007. We included 43 men and 6 women with schizophrenia convicted of homicide who were hospitalized in the forensic psychiatry unit for compulsory treatment. Preset data recording forms were used. The first part of the forms contained questions regarding the age, sex, marital status, residence, educational status, and occupation of the patients. The second part of the forms included questions about some clinical features of patients with schizophrenia: the presence of schizophrenia in any family member, duration of the disease, subtype of schizophrenia, previous contact with mental health services, types of antipsychotics (first and last drug used), and adherence to antipsychotic medication. The third part of the forms dealt with alcohol-substance abuse and features of the victim (sex of the victim and whether the victim was a stranger, partner, or an ex-partner in the family or an acquaintance). The mean +/- SD age of our patients was 36.98 +/- 10.07 years, and 55.1% of the patients were unmarried. In our sample, 42.9% of the patients were primary school graduates and 75.5% were unemployed. Of the perpetrators, 14.3% never had contact with mental health services. However, 85.7% of patients had previous contact with mental health services. We found that 85.7% of the patients were paranoid subtype and 85.7% were not using their medication regularly and that treatment compliance was considerably low. We found that haloperidol and trifluoperazine were the most preferred antipsychotic drugs, particularly being the first drugs used during treatment (haloperidol, 71.4%; trifluoperazine, 10.2%) and the last antipsychotics used before the offence (haloperidol, 46.9%; trifluoperazine, 20.4%). In 38.8% of cases, schizophrenia was present in the first-degree relatives. We also found that 69.4% of victims were one of the family members. In our sample, 24.5% of patients were using alcohol and 4.1% were using cannabis. It is plausible that rendering more effective communication might allow earlier intervention for unrecognized and possibly unrecognizable risk factors of homicidal acts in people with schizophrenia.
在这项研究中，我们旨在描述在土耳其东部地区被判定犯有杀人罪的精神分裂症患者样本的社会和临床特征以及犯罪细节。这项研究是在 2004 年 11 月至 2007 年 5 月期间在埃尔祖鲁姆精神病院进行的。我们纳入了 43 名男性和 6 名女性精神分裂症患者，这些患者因强制治疗而被住院于法医精神病科。使用了预设的数据记录表格。表格的第一部分包含了有关患者年龄、性别、婚姻状况、居住地点、教育程度和职业的问题。表格的第二部分包含了有关精神分裂症患者某些临床特征的问题：任何家庭成员中是否存在精神分裂症、疾病持续时间、精神分裂症亚型、以前是否接触过心理健康服务、抗精神病药物的类型（使用的第一种和最后一种药物）以及对精神分裂症药物的依从性。表格的第三部分涉及酒精-物质滥用和受害者特征（受害者的性别以及受害者是否是陌生人、伴侣、家庭中的前伴侣或熟人）。我们患者的平均年龄为 36.98 +/- 10.07 岁，55.1%的患者未婚。在我们的样本中，42.9%的患者是小学毕业生，75.5%的人失业。在犯罪者中，14.3%的人从未接触过心理健康服务。然而，85.7%的患者以前曾接触过心理健康服务。我们发现，85.7%的患者是偏执型亚型，85.7%的患者没有规律地使用药物，治疗依从性相当低。我们发现氟哌啶醇和三氟拉嗪是最受欢迎的抗精神病药物，特别是在治疗期间（氟哌啶醇，71.4%；三氟拉嗪，10.2%）和犯罪前使用的最后一种抗精神病药物（氟哌啶醇，46.9%；三氟拉嗪，20.4%）。在 38.8%的病例中，一级亲属中存在精神分裂症。我们还发现，69.4%的受害者是家庭成员之一。在我们的样本中，24.5%的患者饮酒，4.1%的患者使用大麻。可以合理地认为，进行更有效的沟通可能会允许对精神分裂症患者未被识别和可能无法识别的杀人行为风险因素进行早期干预。
