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Neonaticide.

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Adult↗

Attempted murder of a newborn: a case history.

In this report we have examined the evaluation of a teenage mother who has attempted murder of her newborn. We have also assessed her for competency to mother the infant she attempted to murder and reassessed the outcome a year later. We argued in this case that with sufficient supervision and psycho-social counselling she could be given the possibility of parenting her infant. Upon follow-up a year later we found the child and mother to be supported within an extended family group and the mother managing the needs of her infant.

Adolescent↗

Homicide followed by suicide: a Quebec case series, 1988-1990.

Homicide followed by suicide is a rare but tragic event. Psychiatrists and mental health professionals are often called upon to comment publicly on the event or to help the "hidden victims," the survivors of the tragedy. There were 39 such cases in Quebec between 1988 and 1990, and they have been reviewed through the examination of the coroner's files. The epidemiological rates of homicide, suicide, homicide-suicide and the sociodemographic and clinical characteristics of the perpetrators and victims are presented and compared with the international literature. Sociological and psychopathological hypotheses are presented with a special reference to the possibility of various subgroups of perpetrators. Research needs to be pursued along the lines of more detailed case studies of psychopathological characteristics using the psychological autopsy approach. The reconstruction of the couple's relationship and of the final circumstances leading up to the tragedy may provide warning indices that could be helpful in preventing such tragedies.

Adolescent↗

Considering suffocatory abuse and Munchausen by proxy in the evaluation of children experiencing apparent life-threatening events and sudden infant death syndrome.

This study describes 138 young children admitted to the hospital over a 23 year period for recurrent apparent life threatening events (ALTEs), unexplained deaths, or with Sudden Infant Death Syndrome (SIDS)-related diagnoses. In examining the potential for suffocatory abuse in living children, we utilized characteristics in the literature that distinguish SIDS or ALTEs due to natural disease states from abuse. Findings demonstrate a co-occurrence of risk factors that raise suspicions of suffocatory abuse or Munchausen by Proxy. Of the 35 children who died, SIDS was the presumed clinical diagnosis at the time of death in 71 % of the cases. Comprehensive chart review and autopsy findings revealed a non-SIDS diagnosis in 54% and confirmed or suspicious child abuse in 37% of these deaths. Reports to Child Protective Services were made in 6% of cases. Recommendations for assessment of children including attention to risk indicators, involvement of child protection teams, mandatory autopsies, and eath scene investigations are offered.

Asphyxia↗

Homicide in the West of Scotland.

Between 1953 and 1974 the author made psychiatric examinations for the prosecution of 400 persons, 367 males and 33 females, accused of the murders of 307 victims, 194 males and 113 females. The 367 males were accused of 273 murders, 172 male and 101 female victims, and the 33 females were accused of 34 murders, 22 male and 13 females victims. The salient features amongst the accused were maleness, youthfulness, the causal importance of alcohol, the rarity of suicide after murder an the high percentage of psychiatrically normal persons: in these last two respects the picture differed from that reported in England and Wales. The normality of these Scottish accused was further shown by the finding that in the decade 1965 to 1974 no material psychiatric abnormality was seen in 90 per cent of the males examined.

Age Factors↗

Epilepsy and violence.

Epileptic automatism and violence are seldom found among temporal lobe epileptics. The case of a 19-year-old girl who killed a 20-month-old child during an epileptic attack is described, and the literature and medico-legal issues are briefly reviewed.

Adult↗

Neonaticide and hysterical denial of pregnancy.

A case illustrating the association between neonaticide and denial of pregnancy is reported. Neonaticide may be a relatively common form of homicide. In some cases it could be preventable, providing the physician responsible for antenatal care is alert.

Denial, Psychological↗