CLINICAL-GENETIC CORRELATIONS IN SCHIZOPHRENIC PATIENTS WHO HAVE COMMITTED MURDER
The authors state that so far specialists lack clear understanding of the mechanism for committing serious offences by schizophrenic patients and that interferes with development of an effective prevention system. The authors claim that the risk of committing murder is much higher among schizophrenics than in general population, and the prevalence of schizophrenics in a sample of murderers may vary from 6% to 20%. Neurobiological alterations in schizophrenia, though they are in the process of investigation, suggest a possible involvement of specific transmitter systems, e.g. the cathecholamine system. The dopamine hypothesis suggests a disbalance between subcortical and cortical dopaminergic systems. There are two principle degradation mechanisms for cathecholamines: either by deamination by monoamine oxidases (MAO) or by methylation by catechol-0-methyltransferases (COMT). The degree of activity of these enzymes is coded by genes MAOA and COMT. The authors report about their investigation of these genes polymorphism. Material: Patients with medium-progressive schizophrenia who agreed to diagnostic procedures and healthy controls. One patient group consisted of 9 men who committed murder; with continuous (4 offenders) or episodic (5 offenders) course of the disease, aged from 32 to 61 years; all being treated in the forensic compulsory treatment system. Another group of schizophrenic patients - without a history of violent behaviours - consisted of men aged 17 to 52 years, with continuous (3 patients) or episodic (8 patients) course of the disease. The control group consisted of 10 men without mental disorders or a history of committing a murder. Investigation did not show a direct connection between the polymorphism of genes MAOA and COMT and the risk of committing a murder by a schizophrenic patient. However, the authors found an association between highly active genotypes, specifically, 4 (MAOA), Met/Val (COMT) and schizoid or unstable premorbid accentuation in patients that committed a murder; and schizoid or unstable accentuation has a correlation with homicide behaviour in schizophrenic patients. One could expect that a highly active genotype significantly influences the development of personality traits that facilitate committing a murder. This result supports the well-known ‘syndrome - personality - situation' concept.