Maternal infanticide associated with mental illness: Prevention and the promise of saved lives
Maternal infanticide associated with mental illness: Prevention and the promise of saved lives
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DOI：
10.1176/appi.ajp.161.9.1548
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发表时间：
2004-09-01
影响因子：
17.7
通讯作者：
Spinelli, MG
中科院分区：
文献类型：
--
作者：
Spinelli, MG
目的：虽然产妇自杀是一种罕见的事件，但很高比例的病例发生在产后精神疾病的背景下。作者回顾了历史，立法，和当代精神病学的观点，并讨论了精神病学社区可以改善预防自杀和促进精神病妇女谁犯下自杀的适当治疗的方法。方法：得克萨斯州诉安德烈·耶茨案，涉及一位患有精神疾病的母亲淹死了她的五个孩子，被用来说明社会的复杂的反应，以产后精神疾病的背景下，对精神疾病的反应的复杂性：在美国，对精神疾病的反应是由司法系统对此类案件的反应。尽管英国的《杀婴法》规定对犯下杀婴罪的患有精神疾病的母亲进行缓刑和精神治疗，但在美国，“杀人母亲”可能面临死刑。当代神经科学的研究结果支持这样一种观点，即患有产后精神病的妇女在犯下杀人罪时需要的是治疗而不是惩罚，适当的治疗将阻止她再次杀人。精神科医生有一个至关重要的作用，在认识到围产期精神疾病的体征和症状，特别是产后精神病，并在早期识别和干预与高危mothers.Conclusions：没有正式的DSM-IV诊断标准产后精神疾病促进不同的治疗根据法律。精神病社区应该制定产后疾病治疗指南，促进精神病学和法律之间的知识共享，并做更多的工作来启发社会对精神疾病对思想和行为的影响，以便有关精神病患者的治疗和惩罚的决定不会完全掌握在司法系统手中。
Objective: Although maternal infanticide is a rare event, a high proportion of cases occurs in the context of postpartum mental illness. The author reviews historical, legislative, and contemporary psychiatric perspectives on infanticide and discusses ways in which the psychiatric community can improve prevention of infanticide and promote appropriate treatment of mentally ill women who commit infanticide.Method: The case of Texas v. Andrea Yates, involving a mother with mental illness who drowned her five children, is used to illustrate society's complicated reactions to infanticide in the context of postpartum mental illness.Results: In the United States, the complexity of the response to infanticide is demonstrated by the judicial system's reaction to such cases. Whereas England's infanticide Law provides probation and mandates psychiatric treatment for mothers with mental illness who commit infanticide, "killer mothers" may face the death penalty in the United States. Contemporary neuroscientific findings support the position that a woman with postpartum psychosis who commits infanticide needs treatment rather than punishment and that appropriate treatment will deter her from killing again. Psychiatrists have a vital role in recognizing the signs and symptoms of peripartum psychiatric disorders, particularly postpartum psychosis, and in early identification of and intervention with at-risk mothers.Conclusions: The absence of formal DSM-IV diagnostic criteria for postpartum psychiatric disorders promotes disparate treatment under the law. The psychiatric community should develop guidelines for the treatment of postpartum disorders, foster sharing of knowledge between psychiatry and the law, and do more to enlighten society about the effects of mental illness on thought and behavior so that decisions about the treatment and punishment of mentally ill persons will not be left exclusively in the hands of the judicial system.