Homicides committed by women with mental disorders: A descriptive study conducted in a French secure unit.

Women remain a small minority of homicide offenders and appear to be understudied in the scientific literature. Gender-specific characteristics are however identified by existing studies. The aim of the study was to explore homicides committed by women with mental disorders, by analyzing their sociodemographic, clinical features, and criminological circumstances of the homicide. We conducted a retrospective and descriptive study among all female homicide offenders with mental disorders hospitalized in a French high-secure unit over a 20-year period (n = 30). We found that the female patients we studied were a diverse group in terms of their clinical profiles, backgrounds, and criminological characteristics. Confirming previous studies, we observed an over-representation of young women, unemployed, with a destabilized family situation and history of adverse childhood experiences. Prior self- and hetero-aggressive behavior were frequent. We found a history of suicidal behavior in 40% of cases. Their homicidal acts often occurred impulsively at home, in the evening or at night and were mainly directed toward family members (60%), especially their child(ren) (46.7%), then acquaintances (36.7%), and rarely a stranger. We found symptomatic and diagnostic heterogeneity: schizophrenia (40%), schizoaffective disorder (10%), delusional disorder (6.7%), mood disorders (26.7%), and borderline personality disorder (16.7%). Mood disorders were exclusively unipolar or bipolar depressions, often with psychotic features. The majority of patients had received psychiatric care prior to the act. We identified four subgroups, according to psychopathology and criminal motives: delusional (46.7%), melancholic (20%), homicide-suicide dynamic (16.7%), and impulsive outbursts (16.7%). We consider that further studies are necessary.

Maternal filicide and mental illness: A descriptive study of 17 women hospitalized in a French secure unit over a 24-year period.

Maternal filicide is defined as the murder of a child by its mother. Many classifications have been elaborated based on underlying motives such as altruism, mental pathology, fatal maltreatment, spousal revenge, or an unwanted child. Pathological filicide refers to cases in which the perpetrator has a major psychiatric illness. Related literature is sparse. The present work proposes to identify the main characteristics of mentally ill filicidal mothers. This study was based on data gathered through a retrospective chart review of all filicidal women admitted to the Henri Colin secure unit (France) between 1996 and 2019 (N = 17). Most filicidal mothers had a dysfunctional childhood marked by emotional neglect, intrafamilial violence, or social isolation. They were often married, on average about 32 years old. We found a history of attempted filicide in 3 cases, and abuse or neglect in 3 other cases. The victim's average age was 6.2 years old, and in several cases, multiple siblings were murdered. Half of the filicidal mothers had a history of psychiatric disorders. Three different diagnoses were found in our study: bipolar or depressive disorders (41.2%); schizophrenia or other psychotic disorders (41.2%); personality disorders (17.6%). We identified two subgroups, as having different motivational profiles. In the first group, filicide is a defensive reaction to a perceived threat: The murder is committed under the influence of hallucinations or delusions. In the second group, filicide is linked to a context of separation, real or imagined. Several forensic and psychopathologic features associated with each profile are detailed.

[Initial training in psychotherapy for psychiatrists in France, a national qualitative study]. / La formation aux psychothérapies des internes en psychiatrie en France : résultats d'une analyse qualitative.

Objectives To explore the level of satisfaction among residents regarding their training in psychotherapies, the interest they have in these therapies, and their wishes in the area of training.Methods A survey including both a quantitative and qualitative methodology was undertaken among 869 residents out of 1,334 enrolled in the psychiatric residency program. In the 2009-2010 academic year. The survey included five themes of study: theoretical academic training, psychoanalysis, training in institutes outside the university, supervision, wishes in the area of training. This article presents results from the qualitative sociological survey using a semi-guided interview with 27 residents. Their conceptions and practice in the field of psychotherapy, and its place in psychiatric practice were questioned in-depth.Results The vast majority of residents were interested in psychotherapy, but simultaneously dissatisfied with the training they had received. Almost half opted for various sorts of extra-curricular training, costly in time and money. The psychotherapeutic orientations among these residents were varied, and a plurality of methods and theoretical approaches was advocated both for reasons of having a wider viewpoint and good practice in psychiatry, and because the residents considered this plurality to be an essential component in their training. They saw psychotherapy as a medical practice, and considered that it is the responsibility of the psychiatric discipline to provide training in psychotherapies.Conclusion The absence of any real training in psychotherapies for residents in psychiatry is damaging for care quality in psychiatry. The recent creation of a protected title of psychotherapist for psychiatrists without the need of additional training suggests an urgent need to develop a training course. A proposal by the authors should be discussed in light of reflections and proposals already underway in other countries.