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Le double parricide, archétype du passage à l’acte schizophrénique ? - 07/05/20

Is double parricide an archetype of schizophrenic acting out?

Doi : 10.1016/j.evopsy.2019.10.001 
Sophie Raymond a,  : Psychiatre des hôpitaux, Camille Larhant a : Interne, Vincent Mahé b : Psychiatre des hôpitaux, Eric Marcel c : Psychiatre des hôpitaux
a UMD Henri-Colin, GH Paul-Guiraud, 54 avenue de la République, 94806 Villejuif, France 
b GHEF, site de Meaux, service de psychiatrie, 6–8 rue Saint-Fiacre, 77100 Meaux, France 
c Institut MGEN de la Verrière, route de Montfort, 783222 Le-Mesnil-Saint-Denis cedex, France 

Auteur correspondant.

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Résumé

Objectif

Le parricide, défini comme le meurtre sur ascendant, représente 2 à 3 % des homicides en France. Si cette incidence est relativement faible, le double parricide (meurtre du père et de la mère) est encore plus rare, estimé à 2 à 3 cas par an. La double horreur du crime semble signer la folie de l’auteur, mais le double parricide est-il réellement archétypique d’un passage à l’acte schizophrénique ?

Méthode

Après une revue de la littérature, nous exposons deux vignettes permettant d’explorer la dynamique psychopathologique de l’acte, en discutant les éléments cliniques et criminologiques.

Résultats

Dans la littérature, à l’exclusion des parricides adolescents (plus rarement le fait d’un trouble mental mais plutôt d’un sujet victime de maltraitance sévère), un profil-type du parricide adulte se dégage : un homme jeune, atteint de schizophrénie paranoïde avec un appoint toxique, une comorbidité antisociale, vivant au domicile parental dans une impasse situationnelle. Dans les cas de double parricide, si les vignettes cliniques de la littérature retrouvent ce profil, les études de cohorte relèvent une hétérogénéité diagnostique (troubles du registre schizophrénique, mais aussi troubles de l’humeur et troubles de la personnalité), également présente dans les deux cas que nous exposons.

Discussion

La revue de littérature et les cas présentés de double parricide mettent en lumière un substratum psychodynamique complexe ainsi qu’une diversité des pathologies psychiatriques en jeu. Si le premier cas apparaît pathologique sur un mode anté-oedipien schizophrénique, le second semble le résultat d’une combinaison entre élation de l’humeur, conflit intrafamilial ancien et motivation émotionnelle.

Conclusion

Les éléments présentés permettent d’ouvrir la discussion et de relativiser la tendance à attribuer les cas de double parricide exclusivement à des troubles du registre schizophrénique. L’analyse de l’acte doit intégrer une réflexion psychopathologique globale incluant l’existence d’éventuelles perturbations de l’humeur, mais aussi une étude de la dynamique familiale dans sa compréhension systémique, afin de préciser le rôle respectif de chacun de ces facteurs dans la génèse du passage à l’acte.

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Abstract

Objective

Parricide, 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?

Method

After 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.

Results

Apart 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.

Discussion

The 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.

Conclusion

These 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.

Il testo completo di questo articolo è disponibile in PDF.

Mots clés : Double parricide, Parricide, Patricide, Matricide, Schizophrénie, Psychodynamie, Diagnostic, Cas clinique, Unité pour malades difficiles, Psychiatrie légale

Keywords : Double parricide, Parricide, Patricide, Matricide, Schizophrenia, Psychodynamics, Diagnosis, Case Report, Psychiatric secure unit, Forensic psychiatry


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 Toute référence à cet article doit porter mention : Raymond S, Larhant C, Mahé V, Marcel E. Le double parricide, archétype du passage à l’acte schizophrénique ? Evol psychiatr 2020; 85 (2) : pages (pour la version papier) ou URL [date de consultation] (pour la version électronique).


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