Lethal violence and psychosis: a clinical profile.
P. G. Nestor, J. Haycock, S. Doiron, J. Kelly and D. Kelly,
Bull. Amer. Acad. Psychiatry & the Law
23(3): 331-41, 1995.
To investigate the relationship between lethal violence and psychosis, the authors examined
symptomatology, neuropsychological functioning, and the nature of perpetrator-victim relationships
of patients with psychotic disorders who were committed to a forensic psychiatric hospital following
violent, primarily criminal behavior. A severely violent group, composed primarily of psychotic
patients charged with murder, was compared with a less severely violent group that was composed
primarily of psychotic patients involved with property crimes. As compared with the less violent
group, the severely violent group was more likely to have delusional beliefs about specific personal
targets and to have delusions about significant others being replaced by impostors. These beliefs
were accompanied by higher scores on neuropsychological tests of intellectual and academic
abilities. A high number of their blood relatives were victims of psychotic murder. These results
indicated that a higher incidence of lethal or near lethal acts of violence may characterize
intellectually intact but psychotic individuals with organize delusions involving personal, accessible