The inpatient evaluation and treatment of a self-professed budding serial killer.
The authors present the case of a man who was hospitalized after claiming that he was about to become a serial killer. The patient presented with extensive written homicidal fantasies and homicidal intentions without evidence of actual homicidal acts. In addition to routine assessments, hospital staff members used case conferences, psychological testing, outside forensic consultation, and a forensic review process to make decisions regarding diagnosis, treatment planning, and discharge. The patient was discharged after 8 months of inpatient treatment and was apparently free of homicidal impulses or symptoms of severe mental illness. A 2-year court commitment allowed for the enactment and potential enforcement of a discharge plan that was endorsed by the patient, the hospital, and community care providers. The authors review diagnostic and risk management issues. Comparisons with known features of typical serial killers are made.
Reisner
Andrew D
AD
Cambridge Psychiatric Hospital, 66737 Old 21 Road, Cambridge, Ohio 43725, USA.
McGee
Mark
M
Noffsinger
Stephen G
SG
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D003134:Commitment of Persons with Psychiatric Disorders; D003987:Dibenzothiazepines / Q000627:therapeutic use; D005201:Fantasy; D005555:Forensic Psychiatry / Q000379:methods; D006708:Homicide; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000523:psychology / Q000534:rehabilitation; D000069348:Quetiapine Fumarate; D018570:Risk Assessment; D012640:Seizures / Q000188:drug therapy; D012650:Self Disclosure
D000927:Anticonvulsants; D003987:Dibenzothiazepines; D000069348:Quetiapine Fumarate