Case of Parricide in the Context of a Depressive Disorder

Jorge González Fernández1; Bernat N Tiffon2; 3

Case of Parricide in the Context of a Depressive Disorder

Jorge González Fernández1*, Bernat N Tiffon2,3

Published Date: 2022-01-31

Jorge González Fernández^1*, Bernat N Tiffon^2,3

¹La Rioja Institute of Legal Medicine and Forensic Sciences, Logroño, Spain

²Department of Legal Psychology, Universitat Abat Oliba (UAO-CEU), Barcelona, Spain

³Department of Criminal Psychology, ESERP Business & Law School, Madrid, Spain

*Corresponding Author:: Jorge González Fernández
La Rioja Institute of Legal Medicine and Forensic Sciences,
Logroño, Spain,
Tel: 34678618417
Email: jgonzalezf@larioja.org

Received date: December 31, 2021, Manuscript No. IPJMTCM -22-12315;

Editor assigned date: January 03, 2022, PreQC No. IPJMTCM -22-12315 (PQ);

Reviewed date: January 13, 2022, QC No. IPJMTCM -22-12315;

Revised date: January 24, 2022, Manuscript No. IPJMTCM -22-12315(R);

Published date: January 31, 2022, DOI: 10.36648/ 2471-641.8.1.6

Citation: Fernández JG, Tiffon BN (2021). Case of Parricide in the Context of a Depressive Disorder. Med Case Rep Vol.8 No.1:6

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Abstract

The death of minors at the hands of one of their parents is a rare event, but with great relevance from a psychopathological perspective.

The case of a mother affected by a major depressive disorder is presented, in which a differential diagnosis must be established between a complete impairment of her intellectual and volitional capacities due to the possible existence of associated psychotic symptoms, and a partial impairment of her knowledge and will by overvaluation of ideas that do not strictly speaking constitute a delusional construct.

Keywords

Parricide; Depressive disorder; Internal emotion; Psychopathology

Introduction

Etymologically, the word “Parricide” comes from the Latin parus, relative, or par, equal, and caedere to kill, and corresponds to the figure contemplated in some civil codes as the homicide of direct, consanguineous relatives or other close relatives. Specifically, the old Spanish penal code stated in its articles that "Whoever kills any of their ascendants or descendants, or spouse, will be punished, as guilty of parricide, with the penalty of imprisonment."

Parricide is a rare crime. A study carried out by Hillbrand in the United States, observed that parricide represents 2% of homicides [1].

The case presented below deals with the death of a minor, caused by their own mother, in which a differential diagnosis could be established between an altruistic homicide associated with suicide, with the intention of the mother to protect her child, and an acute psychotic parricide, in which the crime is perpetrated under the harmful influence of a mental disorder [2]. This case can be contextualized in the series described by Rougé Maillart in 2015, which reflects how the most frequent means of filicide are head trauma, strangulation, asphyxia and drowning, with seven women who attempted suicide [3].

The Case

As stated in the sentence as proven facts, one morning a 34-year-old woman proceeded to bathe her 3-year-old son, placing him in a small bathtub full of water. Due to the pathological influence of her mental dysfunction, she decided to submerge the child's head until he died by suffocation. Then she carefully deposited the now dead minor on her double bed, clothed in pyjama pants and covered him with the blankets. Subsequently, the subject left the house (Figures 1 and 2).

Figure 1: General view of the child's corpse on the bed.

Figure 2: Detail of the child's face. Note: The foam in the mouth.

After wandering aimlessly for quite some time, she came to a deserted place. There she saw a house that she believed to be unoccupied, so she entered it in order to take shelter and spend the night. The next day, she was discovered by the homeowner.

Continuing with what was proven in the sentence, it was considered that, at the precise moment of the events, the defendant suffered from a “major depressive disorder” that seriously affected her conscience and will, although without completely annulling it.

The subject was sentenced to five years and eight months imprisonment, for a crime of murder, with the aggravating concurrence of kinship and the incomplete defence of a mental disorder.

Psychopathological Assessment of the Case

In the psychiatric-forensic evaluation, the subject described a happy childhood; however, she reported that she drastically became sadder during her adolescence, stating that, since then, she had had episodes of a feeling of anguish to which she was accustomed. Seven years before the events, at the age of 27, she went to see a psychologist, who diagnosed her with a major depressive disorder with obsessive symptomatic comorbidity. After a few months of psychotherapeutic intervention and with the improvement of her symptomatological phenomenology, she finished the treatment and immediately got married. Two years later her son was born. Seven months before the events, her husband died suddenly of natural causes and then coinciding with the christmas holidays of that same year, she entered an acute phase of pathological sadness typical of depressive disorders. During the psychopathological examination, a characteristically depressed mood was observed, with apparent affective anaesthesia (or indifference) that led her to relate the details of the death of her son without any type of psycho-emotional reactivity, only shown when referring to the death of her late husband. In the course of the different interviews, this indifference gradually disappeared, approaching normality. In the medicolegal evaluation, reference was made to the existence of a depressed mood, with recurrent ideas of death, alterations in sleeping patterns and appetite that led to a major depressive disorder, in which the absence or difficulty in expressing her feelings and emotions could have determined latency in their externalization. Along with this, the death of her husband, constituted as a compensatory element for her internal tensions, led to a disproportionate and excessive overvaluation of the negative aspects of our sociocultural environment, which created a negative feeling that led to the death of her son "out of love”, and to later, by a passive mechanism let herself die, would conform to an “extended suicide or altruistic homicide”. However, this overvaluation, even though it interfered with her intellectual and volitional capacities, did not establish a complete rupture of her correct judgment of reality, determining a distortion of reality that did not nullify her capacities to think and act. Likewise, it was established that she presented an altered basic personality and yet the maintenance of psychiatric control was proposed, in order to prevent possible self-harming behaviour and for the establishment of therapies appropriate to her basic personality.

A psychological expert’s report was issued at the request of the defence, based on individual, directed clinical interviews (anamnesis), the administration of the TAT (Thematic Apperception Test) projective test and an interview to exchange impressions with the parents. The expert report concluded that the subject presented, then, a recurrent major depressive disorder, a current serious episode with psychotic symptoms congruent with the emotional state, established in an obsessive compulsive disorder. The death of her son occurred in this context of psychotic depression that led to an altruistic homicide or expanded suicide. The delusional ideation (of a psychotic type), congruent with the depressed mood, generated a serious alteration in her perception of reality, which determined that her abilities to think and act at the time of the event were totally nullified.

In a second report issued by the clinical psychologist who treated her, it was established as a final deduction that there was a withdrawn passive-aggressive personality, in comorbidity with a personality with schizoid traits. It was concluded, based on the pathological state of the affective disorder that she suffered, that she presented an episode of major depression, possibly superimposed on schizophrenia, with such fatal consequences. There was a moment when her mind was irreversibly “broken”.

By appointment of the investigating judge, a new opinion was prepared by a specialist in general psychiatry and legal psychiatry based on interviews, a study of the medical reports provided and the assessment of the intensity of depression through the administration of the Montgomery and Asberg scale, reaching the following psychiatric-legal conclusions:

1.The subject had a history of major depressive disorder, for which she received psychotherapeutic treatment. After the death of her husband, she relapsed, suffering a serious major depressive episode.

2.That the events contemplated in the proceedings are included in the context of an expanded concept of suicide.

3.That the patient was in a state of mental derangement due to suffering from a serious depressive disorder with experiences of ruin and catastrophizing, which nullified her ability to understand and love.

4.That she should be treated with antidepressants and psychotherapy.

The report issued by a psychologist at the psychiatric care centre where she was admitted after the events, found that she had a personality characterized by low personal integration, which made it difficult for her to act in the face of external pressures and internal emotional tensions in a balanced way, so that, since the death of her husband, her emotional state had worsened. The lack of a grieving process, together with the arrival of christmas, motivated her intense feelings of hopelessness and of having no meaning in life, desperately taking refuge in the contemplation of, and clinging disproportionately onto, ideas about a more primitive way of life. Faced with the helplessness of her situation and the discomfort that her overvalued ideas produced in herself, she opted for flight and the subsequent extended suicide of her son. The risk of suicide persisted, necessitating psychotherapeutic support and treatment.

In the report issued by a specialist in psychiatry from the same healthcare centre, it was stated that, while the events were taking place, the mental state of the subject did not present a psychotic state in which the personality could be globally affected and all thought disorganized, since memory or motility were little affected. With the available clinical data, the existence was inferred of a state of disconnection from reality and depersonalization of pathological origin and independent of the will, which could have been serious. Both consciousness and perception and many other functions maintained a relative functional integrity, but she moved immersed in a sensation of unreality, where the most important thing was the change of meaning, and in an altered affective state as well as a trance.

On the completion of her sentence, the centre in which she was admitted issued a medical report in which it specified that, gradually, as her depressive state improved, she became aware of the illness and able to evaluate the events that had occurred, the farfetched ideas having disappeared, at which point she began to work on the hope of rebuilding her life. Although she improved from her depressive disorder, the awareness of her life situation due to the events that occurred was reflected in a torpid evolution that, although satisfactory, supposed a risk of serious relapse. For her total reestablishment, it was considered very important that her social rehabilitation should include psychotherapeutic support on being discharged from hospital and with her incorporation into the world of work.

Discussion

The psychiatric or psychological forensic evaluation must be carried out by professionals with sufficient knowledge and experience in the undertaking of their activity before judges and courts. Although experts in health sciences must be in possession of the corresponding official title, this accreditation as a specialist in these certain areas should not be enough if it is not accompanied by specific legal training, which allows them to transmit their science to legal professionals in a clear and understandable way [4].

Rodenburg [5] already stated in 1971 that if some etiological factors associated with the death of minor children at the hands of their parents are known, such as certain types of personality structure and difficulties in maintaining an adequate relationship with children, the association of a depressive disease multiplies the risk of parricide. On the other hand, a study carried out in the United States indicated that psychiatrists underestimated the extent to which depressed mothers thought about harming their children [6]. However, there are cases, such as the present one, in which the clinical picture of the disorder can reach such a level of subtlety that it goes completely unnoticed by professionals, even already experienced ones, to the extent that suicidal acts involving criminal behaviour towards family members are often totally unpredictable and surprising [7]. In these cases, Joiner's consideration that lack of hope is a fundamental psychological correlate of suicide is highlighted [8].

For all these reasons, and by way of prevention, the exhaustive psychiatric and psychological evaluation of mothers with depressive symptoms and harmful thoughts directed towards their minor children should be recommended, of which their intensity and frequency should be assessed.

On the other hand, it can be established that projective tests and objective psychometric tests, although they can help the court to make decisions, are not decisive, because they are not binding for judicial decisions, with the result that there are very few occasions in which depressive disorders are considered as nullifiers of criminal responsibility. Likewise, the use of such projective evidence is not usually in common forensic use in the Spanish judicial system.