Mitterauer B, Sorgo G
Z Rechtsmed. 1982;89(1):25-42. doi: 10.1007/BF00204998.
Using the casuistic presentation of a case of arson with ensuing double murder and extended suicide by jumping over a rock face, we discuss to what extent genetic disposition is important for the formation of reactive-psychotic states that lead to crimes of extreme violence. From the results of protracted research on the previous history of the perpetrator and of his relatives, a multifactorial disposition toward affective psychoses, alcoholism, epilepsy, and suicide was discovered. On the other hand, in the long-term longitudinal observation of the perpetrator, manic depressiveness was diagnosed, which was characterized by a rapid bi-polar phase shift. This supports the opinion of the authors--partially contradictory to the literature--that such affective outbursts, which have apparently arisen purely reactively, but which lead to murder and suicide, in most cases arise on an endogenic basis. In such cases one should not speak of an exclusively reactive depression (mania) before the possibility of an endogenic component has been excluded. The latter, however, can only be detected through precise long-term longitudinal diagnosis and data on the family's psychiatric history. Otherwise, an endo-reactive depression (mania) must be diagnosed. This implies in these cases at least an "irresistible impulse" (Dispositionsunfähigkeit) of the perpetrator.
通过一个纵火案例的决疑法呈现，该案例随后演变为双重谋杀以及从悬崖跳下的扩展性自杀行为，我们讨论了遗传易感性在导致极端暴力犯罪的反应性精神病态形成过程中究竟有多重要。从对犯罪者及其亲属既往病史的长期研究结果来看，发现了对情感性精神病、酗酒、癫痫和自杀的多因素易感性。另一方面，在对犯罪者的长期纵向观察中，诊断出了躁郁症，其特征是快速的双相相位转换。这支持了作者的观点——部分与文献相悖——即这种显然纯粹是反应性产生但导致谋杀和自杀的情感爆发，在大多数情况下是以内因为基础产生的。在这种情况下，在排除内源性成分的可能性之前，不应仅称其为反应性抑郁（躁狂）。然而，后者只能通过精确的长期纵向诊断以及家族精神病史数据来检测。否则，必须诊断为内源性 - 反应性抑郁（躁狂）。这意味着在这些案例中，犯罪者至少存在一种“不可抗拒的冲动”（易感性无能）。
