why do men kill their families?

[wolf]

One of my first, very memorable, patients was a guy who had killed his family. Young adult, early 20s, first schizophrenic break.

This dude was crazy, crazy. Seriously so. He had been telling his family for weeks that he knew they had been replaced by demons. IIRC, he let them know what he intended to do about this.

The family had the opportunity to get him committed. They did not do so.

He murdered both of his parents and seriously injured his brother. The brother somehow managed to make it out of the house and get to a neighbor's who called the police.

The police or the prison ultimately did the commitment papers.

He did not know what he was doing.

That's the kind of case that Not Guilty by Reason of Insanity is made for. He is still hospitalized (not at my hospital. We don't do long term like that). He is still psychotic, even with medications. He will likely never be released from the hospital.

I know another guy, about the same age, maybe younger. His mom was a really nice lady. Had to come in every couple of months and get him committed because he'd be threatening her. So ... one day, when he wasn't psychotic, they had some kind of an argument. I think it may have been over a videogame of some kind.

He killed her, stabbing her 17 or more times, concealed the body, and was only found out because about a week later he was seen by a relative driving her car around town, and the relative knew he wasn't allowed to drive the car. He knew what he was doing, and tried to cover up his crime. Insanity defense wasn't even considered.