ISSN: 0022-1198
CODEN: JFSCA
Page Count: 3

Dementia as a Risk Factor for Homicide
Rayel, MG
Clinical fellow, clinical instructor and professor, Harvard Medical School Massachusetts Mental Health Center Program in Psychiatry and the Law, MA

Gutheil, TG
Clinical fellow, clinical instructor and professor, Harvard Medical School Massachusetts Mental Health Center Program in Psychiatry and the Law, MA

Land, WB
Clinical fellow, clinical instructor and professor, Harvard Medical School Massachusetts Mental Health Center Program in Psychiatry and the Law, MA

(Received 29 January 1998; accepted 23 June 1998)

Abstract

We report a patient with dementia due to B-12 deficiency and syphilis who presented to a forensic hospital after killing his ex-wife with a gun. Despite current awareness on the occurrence of aggression and violence in patients with dementia, there has been no report discussing dementia secondary to an infectious or nutritional origin causing homicide or severe violent behavior. We discuss possible mechanisms and several predisposing factors for violent behavior in the elderly. We also discuss use and access of a gun in demented patients and its complications. We recommend availability of neuropsychiatric assessments in the elderly, limitation of gun access to demented patients and inquiry about weapon possession in the elderly.

Keywords:
forensic science, forensic psychiatry, vitamin B-12 deficiency, syphilis, homicide, violence, elderly, dementia

Paper ID: JFS14510J
DOI: 10.1520/JFS14510J
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