Matricide, parricide, and filicide: Are major mental disorders or personality disorders involved? Assessment of criminal responsibility in Brazilian cases.

Violence committed by individuals with severe mental disorders has become a growing focus of interest among physicians, law enforcement officials, and the general population. Homicide involving relatives, specially parricide, matricide, and filicide, despite the relatively low incidence of these crimes, may be enigmatic, so forensic psychiatrist are frequently called on the courts to answer questions about insanity and criminal responsibility. The current study aims to describe Brazilian cases of parricide, matricide, and filicide associated with presence of major mental disorders and personality disorders, discussing the assessment of criminal responsibility in each case. The case series described were specifically related to people with mental illness, as bipolar disorder, schizophrenia, and borderline personality with comorbidity of drug abuse. Two of them were considered not guilty by reason of insanity, and the other one was considered partially criminally responsible, according to Brazilian Law and Forensic Psychiatric Reports of the cases. The justice determined compulsory psychiatric treatment for all of them. The question of criminal responsibility of individuals with mental disorders is challenging for criminal justice, psychiatry, and society. Adequate treatment is mandatory to prevent crimes involving mental disorders, as shown in literature. The verification of criminal responsibility is essential for persons' adequate referral in any system of criminal law, thus protecting human rights and referring those who need psychiatric treatment.

Cognition As a Therapeutic Target in the Suicidal Patient Approach.

The current considerations about completed suicides and suicide attempts in different cultures call the attention of professionals to this serious public health problem. Integrative approaches have shown that the confluence of multiple biological and social factors modulate various psychopathologies and dysfunctional behaviors, such as suicidal behavior. Considering the level of intermediate analysis, personality traits and cognitive functioning are also of great importance for understanding the suicide phenomenon. About cognitive factors, we can group them into cognitive schemas of reality interpretation and underlying cognitive processes. On the other hand, different types of primary cognitive alterations are related to suicidal behavior, especially those resulting from changes in frontostriatal circuits. Among such cognitive mechanisms can be highlighted the attentional bias for environmental cues related to suicide, impulsive behavior, verbal fluency deficits, non-adaptive decision-making, and reduced planning skills. Attentional bias consists in the effect of thoughts and emotions, frequently not conscious, about the perception of environmental stimuli. Suicidal ideation and hopelessness can make the patient unable to find alternative solutions to their problems other than suicide, biasing their attention to environmental cues related to such behavior. Recent research efforts are directed to assess the possible use of attention bias as a therapeutic target in patients presenting suicide behavior. The relationship between impulsivity and suicide has been largely investigated over the last decades, and there is still controversy about the theme. Although there is strong evidence linking impulsivity to suicide attempts. Effective interventions address to reduce impulsivity in clinical populations at higher risk for suicide could help in the prevention. Deficits in problem-solving ability also seem to be distorted in patients who attempt suicide. Understanding cognitive changes in patients who attempt suicide open an important perspective in the approach of patients with mental disorders. Identifying cognitive deficits in these patients, along with personality traits, depressive symptoms, and suicidal cognitive schemas may indicate to the psychiatrist the need for emergency care. Behavioral and cognitive interventions have been associated with reductions in suicide ideation, as well as suicide attempts in different populations.