Is double parricide an archetype of schizophrenic acting-out?

• Published in: Evolution psychiatrique Vol. 85; no. 2; pp. e1 - e10
• Main Authors: Raymond, Sophie, Larhant, Camille, Mahé, Vincent, Marcel, Eric
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01.05.2020
• Subjects: Clinical Case; Diagnostic; Double parricide; Forensic psychiatry; Matricide; Parricide; Patricide; Psychiatric intensive care unit; Psychodynamic; Schizophrenia; Forensic psychiatry; Psychiatric intensive care unit; Clinical Case; Parricide; Matricide; Patricide; Schizophrenia; Psychodynamic; Double parricide; Diagnostic
• ISSN: 0014-3855; 1769-6674
• DOI: 10.1016/j.evopsy.2020.03.001

Parricide, defined as the act of killing one's parent by a child, represents 2 to 3% of all homicides in France and North America, an incidence rate that remains relatively stable. This particular murder seems, to most people, an unthinkable act of violence andhas been a source of fascinationsince antiquity, becoming a founding myth. Double parricide (the murder of both parents) is less frequent, accounting for 2 to 3 cases per year in France. The double horror of the crime seems to definitively mark the offender as mad, but is the double parricide really the archetype of a schizophrenic acting-out? After a review of the scientific literature, we present two cases in order to explore the psychopathological profile of double parricide, by discussing clinical and criminological features. Apart from adolescent parricides (more rarely due to a mental disorder but rather to a subject suffering from severe abuse), characteristic features of mentally ill adult parricides emerge from the review of literature. Offenders are mostly young men, suffering from paranoid schizophrenia with persecutory delusions, substance use and/or antisocial comorbidity, living at the parental home. With regard to double parricide, case reports of the literature are consistent with this profile, but cohort studies find a real heterogeneity concerning the diagnosis (schizophrenia spectrum, but also mood disorders and personality disorders). We then describe two different cases of double parricide. The first patient, aged 22 and diagnosed with schizophrenia, commits a double parricide in a delusional context with mysticism and persecution. There is no premeditation, but a precipitating factor (a trivial dispute), and a history of repeated conflicts with his stepmother. The act is characterized by its brutality and a grandiose atmosphere, without remorse afterwards. The second patient, in her fifties, kills both parents during a partly premeditated, organized acting-out, with dissimulation. The double parricide occurs in a context of anger and even rage, rooted in a history of childhood abuse and exalted by an unstable psychological state due to a decompensated bipolar disorder. The literature review and our reported cases of double parricide highlight a complex psychodynamic substratum as well as the variety of psychiatric pathologies involved. If the first case appears to be pathognomonic of schizophrenic disorders, the second seems to be the result of a combination of mood elation, unresolved intrafamilial conflict, and emotional motivation. These results underline the excessive trend to attribute double parricide cases exclusively to schizophrenic disorders. However, one of our cases demonstrates that double parricide may be related to mood disorders and/or severe abuse. Thus, double parricide cannot be said to be the archetype of schizophrenia, and an analysis of the act should make use of a general psychopathological reflection that would include the existence of possible mood disturbances, as well as a systemic study of the family dynamic.