Le double parricide, archétype du passage à l’acte schizophrénique ?

Abstract

ObjectiveParricide, defined as the killing of a parent by a child, accounts for 2 to 3% of all homicides in France and North America, an incidence rate that remains relatively stable. Considered by most to be an unthinkable act of violence, parricide has fascinated human beings since antiquity, becoming a founding myth. Double parricide (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 signal the offender's delirium, but is double parricide really characteristic of schizophrenic acting out? MethodAfter a review of the scientific literature, we report two cases in order to explore the psychopathological profiles of perpetrators of double parricide, discussing clinical and criminological features. ResultsApart from adolescent parricides (more rarely the result of a mental disorder but rather concerning subjects suffering severe abuse), characteristic features of mentally ill adult perpetrators of parricide emerge from the review of literature. Offenders are mostly young men presenting paranoid schizophrenia with persecutory delusions, substance use and/or antisocial comorbidity, living at the parental home. With regard to double parricide, case reports in the literature are consistent with this profile, but cohort studies find a real heterogeneity concerning diagnosis (schizophrenia spectrum, but also mood disorders and personality disorders). We describe two different cases of double parricide. The first patient, aged 22 and diagnosed with schizophrenia, committed a double parricide in a delusional context involving mysticism and persecution. There was no premeditation, but a precipitating factor (a trivial dispute), and a history of repeated conflicts with his step-mother. The act was characterized by a brutal killing and a megalomaniac atmosphere, without remorse afterwards. The second patient, in her fifties, killed both parents during a partly premeditated, organized acting out, with dissimulation. The double parricide occurred in a context of anger and even rage, rooted in a history of abuse since her childhood and exalted by an unstable psychological state due to a decompensated bipolar disorder. DiscussionThe literature review and our reported cases of double parricide highlight a complex psychodynamic substratum as well as the involvement of a variety of psychiatric pathologies. If the first case appears to be pathognomonic of schizophrenic disorders, the second seems to be the result of a combination of elated mood, long-standing intrafamilial conflict and emotional motivation. ConclusionThese results underline the excessive trend of attributing double parricide cases exclusively to schizophrenic disorders. Alongside, one of our cases demonstrates that double parricide can be related to mood disorders and / or severe abuse. Therefore, double parricide is not characteristic of schizophrenia and the analysis of the act should integrate psychopathological reflection, including possible mood disorders, and should also study family dynamics in its systemic understanding.