Mentally-ill patients charged with homicide

To describe the clinical, social and demographic features of mentally ill patients charged with homicide.

Retrospective study.

The study was based on the review of case notes of the patients who were charged with homicide and referred to the mental hospital, Peshawar, between 1988 and 1998 for psychiatric evaluation.

The case notes of all the patients referred for psychiatric assessment between 1988 and 1998 were retrieved. Fifty cases with complete essential information were selected for the study. The details of patients, demographic, clinical characteristics, diagnosis, events leading to the homicide, opinion of the medical board, details of the victim and possible provoking factors were recorded on a performa designed for this purpose.

Out of 50 patients referred for psychiatric assessment with homicide, majority (49) were males, while only one was female. The mean age of the sample was 32.4 years and 30 patients (60%) were educated. Schizophrenia was the most frequent diagnosis (72%). Duration of illness in 96% of the patients was more than one year. Only 12 patients had received some form of treatment before the index crime. Thirty-eight (76%) patients were involved in single murder, while 12 patients were involved in multiple homicides. Majority of the victims (39 out of 64) were close relatives of the patients.

Young male patients are mostly referred for psychiatric assessment after homicide. Close relatives are major victims. Lack of adequate psychiatric treatment is one of the contributing factors. Lack of adequate forensic psychiatric services are also highlighted by this study.