Some factors related to guilty behavior in patients with mood disorders

Objectives: To study some factors related to guilty behavior in patients with mood disorders. Subjects and methods: A prospective study on 83 patients with mood disorders (69 depressive disorders, 14 mental disorders) ranged from 20 to 69 years of age, was conducted by law enforcement agencies for mental health assessment from February 2012 to March 2017 at Bienhoa National Institute of Forensic Psychiatry.

SOME FACTORS RELATED TO GUILTY BEHAVIOR IN

PATIENTS WITH MOOD DISORDERS

Nguyen Thanh Quang*; Bui Quang Huy**; Ngo Ngoc Tan**

SUMMARY

Objectives: To study some factors related to guilty behavior in patients with mood disorders Subjects and methods: A prospective study on 83 patients with m ood disorders (69 depressive disorders, 14 mental disorders) ranged from 20 to 69 years of age, was conducted by law enforcement agencies for mental health assessment from February 2012 to March 2017 at Bienhoa National Institute of Forensic Psychiatry Results: Pathological factors predominated in 60.24% of guilty patients Socio-psychological stress was present in 19.28% of these patients and 12.05% of the patients often use alcohol-beer Most patients committed crimes in the progression of the diseases (66.27%) Most guilty behaviors were closely associated to the relationship between patients and victims There was no difference in criminal acts between men and women Such behaviors as homicide and then suicide, public disturbances and other forms of offense are mainly encountered in the age of over 40 The symptoms

of delusions, hallucinations do not have a siginificant effect on the offense of patients Conclusion: Pathological factors are very common in patients with mood disorders Most patients commit crimes during progression of disease, but delusion and hallucinations do not affect markedly the offense of patients

* Key words: Mood disorder; Guilty behavior; Criminal act; Offense

INTRODUCTION

Guilty bahavior in patients with mood

disorders is of great popularity, being

public’s great concern, however, it creates

discrimination against mental illness

According to Sadock B.J (2007), these

behaviors include theft, intentionally inflicting

injury, financial fraud, homicide, murder

followed by suicide

The offenses of patients with mood

disorders are governed by many external

factors A study on the factors involved

in criminal acts will help the mental health

industry as well as law enforcement agencies reduce criminal rate in these patients Because of these above reasons, we conducted this study

SUBJECTS AND METHODS

- A prospective study on 83 patients with mood disorders (69 depressive disorders,

14 mental disorders), 20 to 69 years of age, were conducted by law enforcement agencies for mental health assessment from February 2012 to March 2017 at Bienhoa National Institute of Forensic Psychiatry

* Bienhoa National Institute of Forensic Psychiatry

** 103 Military Hospital

Corresponding author: Bui Quang Huy (bshuy2003@yahoo.com)

Date received: 11/07/2017

Date accepted: 21/11/2017

- Use the item F3 from diagnostic criteria of ICD-10 (1992) for mood disorder

- Use cross-sectional descriptive research The data was processed and analyzed

on IBM SPSS statistic 20 program

RESULTS

Table 1: Some pathological and exotic factors that provoke offense

N° Statistic analysis

The results in the table show that 60.24% of criminally ill patients were affected by mood disorders and only 39.76% of the offenders were due to non-pathological conditions The difference was not statistically significant with p > 0.05 (Binomial = 50.00; p = 0.079)

Of the exogenous factors, psychosocial stress accounted for the highest proportion (19.28%), financial difficulties (16.87%), alcohol use (12.05%), family conflict (10.84%), drug abuse (4.82%), and history of childhood injuries (2.41%) and other motivating factors (3.61%) This finding is consistent with Kaplan H.I’s (1994), who argues that the majority of crimes are due to pathological factors and exogenous factors such as psychosocial stress, alcohol abuse, familial conflict push off the offender's mental disorder

Table 2: Different stages of illness at the time of the patients’ offense

N°

Offenses Period

Patients

Table 2 shows that committing crimes during the progressive stage of illness was the highest (66.27%), followed by disease-free period (27.71%) and in the period of stabilization, guilty behavior accounted for only very low rate (6.02%) The difference

was statistically significant with p < 0.001 2(2) = 46.36; p = 0.000) According to DSM 5 (2013), patients with bipolar disorder tend to commit most crimes in the course of disease progression, with only a small proportion of patients committing offenses during the stable period of their illness

Table 3: The relationship between victims and the forms of criminal acts in patients

with mood disorders

Victims Forms of

criminal acts

Family members

Neighbors and friends

Strange persons

Social

> 0.05

Investigating the relationship between the victim and forms of offense shows a wide variety of behaviors, but there was statistically insignificant difference in the act of intentionally inflicting injury, theft and public disturbances (p > 0.05, with Fisher's Exact Test = 5.428, 1.822, 4.032, p = 0.123, 0.742, and 0.157) The victim are mainly murders’ relatives (33.33%), friends and neighbors (34.78%) Murder followed by suicide is most likely to harm family members (53.33%) Most of the strange people were subjected to robbery (25.00%) The differences were statistically significant with different values p < 0.01 and p < 0.001 (Fisher's exact test = 9,610 to 25,610,

p = 0.008 to 0.000)

The most common victims were social organizations (69.23%), followed by unrelated people (43.75%) neighbors and friends (34.78%) The difference was statistically significant with p < 0.01 (2 (3) = 16.974; p = 0.001) Our study is in line with the opinion of Dan J Stein (2006), Ngo Van Vinh (2011), who argued that homicide, suicide followed by homicide occur to either relatives or neighbors of the patients

Table 4: Relationship between sex and forms of offense in patients with mood disorders

Sex

Forms of offense

p

> 0.05

There was not statistically significant difference between male and female offenders (p > 0.05; with 2 = between 0.418 - 3.213 and p = 0.073 - 0.518 and Fisher's exact test with p = 0.477 - 1.000)

Table 5: Relationship between age and forms of offense in patients with mood disorders

Years of age

Intentional injury

Homicide

Murder followed by suicide

Robbery

Public disturbances

Other forms of offense

Table 5 shows that the behavior of intentional injuries at the age of 30 took up 50.00%, the robbery and homicide aged 20 accounted for 77.78% and 57.14% in the group, respectively; Having committed crimes of homicide then suicide, public disturbances

and other forms of offense were encountered mainly in the age of over 40 with the rate

of 62.50%; 100% and 54.84% in each group The difference was statistically significant with p < 0.01 (Fisher's exact test = 23.816, p = 0.007) Our findings were similar with Kaplan H.I’s (1994), who argued that murder followed by suicide is the most frequent in elderly patients These results were consistent with Ngo Van Vinh’s (2011) who recognized that the types of offenses were found in all age groups

Table 6: Relationship between psychosis and forms of offense in patients with mood

disorders

Psychosis

Forms of offense

p > 0.05

The results of the survey show that the data were different, but offenses such as intentional injury, murder, murder and subsequent suicide, theft, robbery and other forms

of crime were not related to psychotic symptoms The difference wasn’t statistically significant with Fisher's exact test = 10.025, p = 0.977

This finding was corresponding with Sadock B.J (2007), who argues that patients with psychosis mood disorders are not different from patient with non-psychotic mood disorders

CONCLUSION

- The pathological factors that governed

the offense were found in 60.24% of the

patients The psycho-social stress factor

was found in 19.28% and the common

alcohol use was found in 12.05% of the

patients

- Most patients commit crimes in the course of disease progression (66.27%)

- Victims tend to be closely related to

or have relationship with the offenders, except for theft and intentional injury

- There isn’t difference in forms of offense such as intentionally inflicting injury, homicide,

murder followed by suicide, theft between

male and female offenders

- Such criminal acts as homicide then

suicide, public disturbances and other forms

of offense are encountered mainly in the

age of over 40

- Psychosis symptoms such as delusions

and hallucinations haven’t had significant

effect on the patients' criminal acts

REFERENCES

1 Ngo Van Vinh Epilepsy in forensic

psychiatric assessment Psychiatry Subject,

8/4 Medical Publishing House Hanoi 2011

2 American Psychiatric Association

Diagnostic and statistical manual of mental disorder Fifth edition 2013

3 Dan J Stein, David J Kupfer, Alan F Schatzberg Textbook of mood disorders

Volume 1 American Psychiatry Publishing First edition 2006

4 Kaplan H.I, Sadock B.J, Grebb J.A

Synopsis of a Psychiatrist Second edition William and Wilkins 1994

5 Sadock B.J, Sadock V.A Concise Textbook

of Clinical Psychiatry Second edition William and Wilkins 2004