Homicidal ideation: Difference between revisions

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===History and Symptoms===
===History and Symptoms===
The majority of patients with [disease name] are asymptomatic.
Violence is the act of purposefully hurting someone and is a concerning issue amongst the youth.There could be a number of reasons that people act violently which might end up in being homicidal or suicidal. Individuals should be assessed for the following signs to diagnose homicide.<ref>{{cite web |url=https://www.apa.org/topics/physical-abuse-violence/youth-warning-signs |title=Warning signs of youth violence |format= |work= |accessdate=}}</ref>


OR
• A history of violent or aggressive conduct
• Been a target of bullying
• Difficulty in disciplining or numerous disagreements with authority
• Childhood abuse or neglect at young age
• Living in a violent home environment
• Family or parent tolerates violence
• A history of cruelty to animals
• Having a parent with mental illness
• Serious drug or alcohol use
• Access to fire arms
• Difficulty with anger management


The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
Other alarming signs could be
• Engaging in fights
• Increased use of alcohol or drugs
• Increased risk-taking conduct
• Acute episode of major mental illness
• Strategies to commit violence
• Broadcasting threats or plans for hurting others
• Obtaining or carrying a weapon


===Physical Examination===
===Physical Examination===
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
Non contributory
 
OR
 
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
 
OR
 
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].


===Laboratory Findings===
===Laboratory Findings===
Line 175: Line 180:


There are no diagnostic laboratory findings associated with [disease name].
There are no diagnostic laboratory findings associated with [disease name].
===X-ray===
There are no x-ray findings associated with homicidal ideation.


<br />
<br />
===CT scan===
There are no CT scan findings associated with [disease name].
OR
[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
===MRI===
There are no MRI findings associated with [disease name].
OR
[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].


===Other Diagnostic Studies===
===Other Diagnostic Studies===
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Previous studies have shown that the interval between deciding to act and attempting suicide can be as brief as 10 minutes or less, and that persons tend not to substitute a different method when a highly lethal method is unavailable or difficult to access (''8'',''9''). Reducing access to lethal means during an acute suicidal crisis by safely storing firearms or temporarily removing them from the home can help reduce suicide risk, particularly among youths (''7''). Preventing persons convicted of or under a restraining order for domestic violence from possessing a firearm has been associated with reductions in intimate partner-related homicide, including firearm homicide (''10''). Efforts to strengthen the background check system to better identify persons convicted of violent crimes or at risk for harming themselves or others might also prevent lethal firearm violence, although these policies need further study (''10'').<ref>{{cite web |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6223957/ |title=Firearm Homicides and Suicides in Major Metropolitan Areas — United States, 2012–2013 and 2015–2016 |format= |work= |accessdate=}}</ref>
Previous studies have shown that the interval between deciding to act and attempting suicide can be as brief as 10 minutes or less, and that persons tend not to substitute a different method when a highly lethal method is unavailable or difficult to access (''8'',''9''). Reducing access to lethal means during an acute suicidal crisis by safely storing firearms or temporarily removing them from the home can help reduce suicide risk, particularly among youths (''7''). Preventing persons convicted of or under a restraining order for domestic violence from possessing a firearm has been associated with reductions in intimate partner-related homicide, including firearm homicide (''10''). Efforts to strengthen the background check system to better identify persons convicted of violent crimes or at risk for harming themselves or others might also prevent lethal firearm violence, although these policies need further study (''10'').<ref>{{cite web |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6223957/ |title=Firearm Homicides and Suicides in Major Metropolitan Areas — United States, 2012–2013 and 2015–2016 |format= |work= |accessdate=}}</ref>


===Secondary Prevention===
<br />
There are no established measures for the secondary prevention of [disease name].
 
OR
 
Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3].


==References==
===References===
{{reflist|2}}
{{reflist|2}}
{{Reflist|2}}
{{Reflist|2}}

Revision as of 16:00, 14 June 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hafsa Ghaffar, M.B.B.S[2]

Synonyms and keywords:

Overview

Homicide is defined by law as, " when one human being causes the death of another" [1]. Homicidal ideation refers to thoughts, consideration or planning of homicide [2]. Homicide is not always illegal, in forensic law illegal homicide can range from murder and manslaughter. There is an established difference between illegal and justified homicide.[3]. Homicidal ideations can be due to a mental illness such as schizophrenia, but is not always a result of some mental health issue. Homicidal ideation is one of the psychiatric emergencies. Homicide is different from suicide, which means a person want to harm themselves. A patient who is suicidal might also have homicidal ideations, a risk assessment is used for the diagnosis[4]. The homicide rate world wide[5][6]

Classification

Fire Arm Homicide

Fire arm homicide is a continuing public concern in the United states, It was the 16th leading cause of death among persons of all ages and the third leading cause among youths aged 10–19 years during 2015-2016. A firearm injury was the primary cause of death in 74% of all homicides and in 87% of youth homicides.Earlier there was a declining trend of firearm homicide with a rising trend recently within large metropolitan cities.[7]

Factitious Homicide

Homicidal ideation is often concoct by psychiatric patients in both the emergency room and inpatient settings.These patients claim to have homicidal ideation but do not actually have homicidal thoughts. They may do this for a variety of reasons, e.g. to earn attention, to compel a person or people for or against some action, or to avoid social or legal obligation for eg; temporary relief from complications of substance abuse, illicit reasons, homelessness or primarily to stay in role of patient. Such cases raise both forensic and clinical questions and reinforces the that further investigation is required to develop more sophisticated methods of detection, evaluation, and treatment of factitious disorder with psychological symptoms. [8]

Psychophysiology

Homicidal ideation is associated with serious psychiatric and behavioural problems and has important implications for offender typologies and homicidality. Numerous conditions present likely with homicidal ideation including antisocial personality disorder (2406%), schizoaffective disorder (1821%), borderline personality disorder (1557%), paranoid personality disorder (1,504%), schizophrenia (1,143%), obsessive-compulsive personality disorder (921%), brief psychotic disorder (771%), unspecified psychosis (737%), avoidant personality disorder (596%), and schizoid personality disorder (571%), delusional disorder (546%), and other psychotic disorder (504%).[9]

Differentiating Homicidal ideation from other Diseases

people who are homicidal have higher chances of developing other psychological conditions, this includes suicidal ideation, psychosis, delirium or intoxication.[6] Homicidal ideation can be differentiated from suicidal ideation. Suicidal ideation, also known as having suicidal thoughts means planning, thinking about suicide. Suicidal behaviour can be specified as a spectrum that ranges from fleeting suicidal thoughts to completed suicide. It is often observed in association with depression and other mood disorders. Suicidal ideation is more common than suicide attempt or suicide death.

In one study, it shows that people with schizophrenia can become violent and commit homicide. Homicidal ideation may become apparent in relation to behavioural conditions such as personality disorder (particularly conduct disorder, narcissistic personality disorder and antisocial personality disorder). A study in Finland manifest an increased risk of violence from people who have antisocial personality disorder, which is greater than the risk of violence from people who have schizophrenia.[8] The same study also adduce that many other mental disorders are not associated with an increased risk of violence, of note: depression, anxiety disorders and intellectual disability.[10] [11] [12]

Epidemiology and Demographics

According to the existing data, the homicide rate pre year is more than half a million.

OR

In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.

OR

In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate of [number range]%.


Patients of all age groups may develop [disease name].

OR

The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.

OR

[Disease name] commonly affects individuals younger than/older than [number of years] years of age.

OR

[Chronic disease name] is usually first diagnosed among [age group].

OR

[Acute disease name] commonly affects [age group].


There is no racial predilection to [disease name].

OR

[Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].


[Disease name] affects men and women equally.

OR

[Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.


The majority of [disease name] cases are reported in [geographical region].

OR

[Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].

Risk Factors

There are no established risk factors for [disease name].

OR

The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].

OR

Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

OR

Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.

Risk Assessment

It is important to recognise the risk for homicidal ideation, there should be thorough investigation regarding current homicidal desire ;if the person is at risk of harming their partner, their intent, plan and means, especially past violence and protective factors. clinicians should determine imminent risk; does the client believe that violence is a justified or normal response to situation. develop and document a collaborative intervention plan.

A questionnaire should be filled in a compassionate, supportive, client-centred environment. Questions should be asked regarding means, plans, access to means and protective factors. Analyse about past violent experiences, monitor periodically and document all necessary information.[13] [14]

Natural History, Complications, and Prognosis

If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

OR

Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].

OR

Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.

Diagnosis

Diagnostic Study of Choice

The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].

OR

The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].

OR

The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].

OR

There are no established criteria for the diagnosis of [disease name].

History and Symptoms

Violence is the act of purposefully hurting someone and is a concerning issue amongst the youth.There could be a number of reasons that people act violently which might end up in being homicidal or suicidal. Individuals should be assessed for the following signs to diagnose homicide.[15]

• A history of violent or aggressive conduct • Been a target of bullying • Difficulty in disciplining or numerous disagreements with authority • Childhood abuse or neglect at young age • Living in a violent home environment • Family or parent tolerates violence • A history of cruelty to animals • Having a parent with mental illness • Serious drug or alcohol use • Access to fire arms • Difficulty with anger management

Other alarming signs could be • Engaging in fights • Increased use of alcohol or drugs • Increased risk-taking conduct • Acute episode of major mental illness • Strategies to commit violence • Broadcasting threats or plans for hurting others • Obtaining or carrying a weapon

Physical Examination

Non contributory

Laboratory Findings

An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].

OR

Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

OR

[Test] is usually normal among patients with [disease name].

OR

Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].

OR

There are no diagnostic laboratory findings associated with [disease name].


Other Diagnostic Studies

There are no other diagnostic studies associated with [disease name].

OR

[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

There is no treatment for [disease name]; the mainstay of therapy is supportive care.

OR

Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].

OR

The majority of cases of [disease name] are self-limited and require only supportive care.

OR

[Disease name] is a medical emergency and requires prompt treatment.

OR

The mainstay of treatment for [disease name] is [therapy].

OR   The optimal therapy for [malignancy name] depends on the stage at diagnosis.

OR

[Therapy] is recommended among all patients who develop [disease name].

OR

Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].

OR

Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].

OR

Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].

OR

Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].

Primary Prevention

Previous studies have shown that the interval between deciding to act and attempting suicide can be as brief as 10 minutes or less, and that persons tend not to substitute a different method when a highly lethal method is unavailable or difficult to access (8,9). Reducing access to lethal means during an acute suicidal crisis by safely storing firearms or temporarily removing them from the home can help reduce suicide risk, particularly among youths (7). Preventing persons convicted of or under a restraining order for domestic violence from possessing a firearm has been associated with reductions in intimate partner-related homicide, including firearm homicide (10). Efforts to strengthen the background check system to better identify persons convicted of violent crimes or at risk for harming themselves or others might also prevent lethal firearm violence, although these policies need further study (10).[16]


References

  1. https://www.law.cornell.edu/wex/homicide#:~:text=Homicide%20is%20when%20one%20human,like%20insanity%20or%20self%2Ddefense.
  2. Stern, Theodore F; Schwartz, Jonathon H; Cremens, M Cornelia; Mulley, Albert G. The evaluation of homicidal patients by psychiatric residents in the emergency room: A pilot study. Psychiatric Quarterly. 1991; 62(4): 333–344.
  3. https://criminal.findlaw.com/criminal-charges/homicide-definition.html
  4. http://www.acbhcs.org/providers/QA/docs/2013/TR_Suicide-Homicide_Risk_Assesment.pdf
  5. https://www.statista.com/statistics/251877/murder-victims-in-the-us-by-race-ethnicity-and-gender/
  6. "UNODC Statistics Online". United Nations Office On Drugs and Crime. Retrieved 12 May 2018.".
  7. "Firearm Homicides and Suicides in Major Metropolitan Areas — United States, 2012–2013 and 2015–2016".
  8. "A case of factitious homicidal ideation - PubMed".
  9. Template:Homicidal Ideation and Forensic Psychopathology: Evidence From the 2016 Nationwide Emergency Department Sample (NEDS)
  10. Asnis, Gregory; Kaplan, Margaret; Hundorfean, Gabriela; Saeed, Waheed (June 1997). "Violence and homicidal behaviors in psychiatric disorders". The Psychiatric Clinics of North America. 20 (2): 405–425. doi:10.1016/S0193-953X(05)70320-8. PMID 9196922.
  11. Walsh, Elizabeth; Buchanan, Alec; Fahy, Thomas (2002). "Violence and schizophrenia: examining the evidence". British Journal of Psychiatry. 180 (6): 490–495. doi:10.1192/bjp.180.6.490. PMID 12042226.
  12. Eronen, M; Hakola, P; Tiihonen, J (June 1996). "Mental disorders and homicidal behavior in Finland". Archives of General Psychiatry. 53 (6): 497–501. doi:10.1001/archpsyc.1996.01830060039005. PMID 8639032.
  13. Bland RD, Clarke TL, Harden LB (February 1976). "Rapid infusion of sodium bicarbonate and albumin into high-risk premature infants soon after birth: a controlled, prospective trial". Am J Obstet Gynecol. 124 (3): 263–7. doi:10.1016/0002-9378(76)90154-x. PMID 2013.
  14. "Basic Homicide Risk Assessment - Dustin K MacDonald".
  15. "Warning signs of youth violence".
  16. "Firearm Homicides and Suicides in Major Metropolitan Areas — United States, 2012–2013 and 2015–2016".


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