Prevalence, dynamics and causes of homicides committed by alcoholics (forensic psychiatric and regional aspects)

Background. The dynamic and forensic psychiatric aspects of murders committed by patients with alcohol dependence are of diverse scientific and practical interest, especially at the regional level. Objective: to study the incidents of murders commit-ted by patients with alcohol dependence over a 10-year period (2011-2020) in Chuvashia, as well as their comparison with murders committed by mentally healthy people. Materials. To determine the presence/absence of a mental disorder (MD), a forensic psychiatric examination was conducted (n=507), based on the results of which two groups of persons who commit-ted murders were formed: 1) the main group (n=102), consisting of persons with an ICD-10 diagnosis of Dependence syn-drome (F1x.2) (hereinafter referred to as AD), including 75 men and 27 women aged 25-67 years (mean age 46.9±9.3 years); 2) a comparison group (n=139), which included subjects without MD, including 113 men and 26 women aged 17-66 years (mean age 37.7±12.7 years). Methods: forensic psychiatric examination, clinical-psychopathological, clinical-dynamic, psy-chological analysis of crimes, socio-demographic, statistical. Mathematical and statistical processing was carried out using descriptive statistics and the nonparametric Pearson criterion χ2. Results. An insignificant difference was found between the number of persons with AD and without MD who committed murder (20.1% versus 27.4%). 100% of subjects were found to be sane at the time of the crime. Among those examined with AD, most murders (98%) were committed by one perpetrator, most perpetrators (99%) took the life of one person, the victims of the crime were most often a spouse (38.2%), acquaintances (36.3%) and participants in a joint drinking party (27.5%). 100% of those who committed murders and 84.3% of their victims were in a state of alcoholic intoxication, joint drinking of alcoholic beverages was revealed in 78.4% of cases. Strong alcoholic beverages were consumed by 60.8% of those who committed murders, alcohol substitutes ‒ 34.3%. Of the murder weapons used there were most often (72.5%) bladed articles. The majority of those who committed murders had a low level of education (80.4%), lived with their spouse (62.7%), had previously been convicted of committing crimes (64.7%). Episodes of suicidal behavior in the anamnesis were observed in 34.4% of those who committed murder. Women with AD statistically significantly (p<0.001) more often killed their spouses and used bladed articles to cause death, men with AD statistically significantly (p=0.025) more often took the lives of acquaintances and resorted to strangulation of victims. Comparison of those who com-mitted murder with AD and without MD showed statistically significant differences in marital status, age, education level, and place of residence. Patients with AD more often killed their spouses and accomplices in joint alcohol consumption, persons without MD ‒ minors. Those who committed murder with AD were more often intoxicated at the time of the crime, used alco-hol substitutes, persons without MD more often drank beer before committing the murder and after the tort they more often underwent inpatient forensic medical examination. Conclusion. Individuals diagnosed with alcohol dependence syndrome of-ten commit murders against the background of ongoing intensive alcohol abuse in an asocial environment, have a long criminal history, and are characterized by unstable emotional states, circumstances generally provoking crimes and aggravating their unfavorable outcomes.