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In terms of gene location causing depression, recent research shows that some common genes that cause depression may originate from a specific area of the chromosome 2q33-34, 3p, 12q, 15q and 18q.. . , . It is these disease-causing genes that are pa
from generation to generation, which makes depressive disorder of
⁕ Hypothesis of neurotransmitters
In 2011, Gelder M.G. et al suggest that neurotransmitters such as
serotonin, noradrenalin, and dopamine play an important role in the
pathogenesis of depression. The author thinks there is a decrease in
serotonin levels in the brains of depressed patients .
126.96.36.199. Bipolar disorder
⁕ Genetic hypothesis
Genetic linkage studies of bipolar disorder have shown results in
many genes, many areas with evidence for association, particularly
with chromosome 13q14-32, Xp22, Xq26-28 .
⁕ Hypothesis of neurotransmitters
Psychiatrists have admitted that dopamine abnormalities are
related to the occurrence of severe manic episodes, and that
noradrenalin is associated with mild mania , .
1.1.3. Clinical features of mood disorder
188.8.131.52. Clinical features of depressive episode
⁕ Main symptoms
+ depressed mood must present for most of the day and almost
+loss of interest and enjoyment for most activities: loss of
interest and enjoyment always manifests at a certain level
+ reduced energy leading to increased fatigue ability and
diminished activity. Marked tiredness after only slight effort is
⁕ Common symptoms
+ Changes in eating, appetite and weight: 95% of patients have
significant weight loss.
+ Disturbed sleep: Insomnia is the most common type of people
with typical depression (accounting for 95% of cases).
+ Change in psychomotor activity, with agitation or retardation
+ Diminished ability to think or concentrate, make decision: It is
difficult for patients to make decisions or to have trouble in thinking,
concentration and attention 
+ Bleak and pessimistic views of the future
+ Ideas of guilt and unworthiness: Depressed patients have
negative views about the world around them and themselves 
+ Ideas or acts of self-harm or suicide: About two-thirds of
depressed patients have ideas, suicidal behaviors and 10% to 15%
succeed in suicide
184.108.40.206. Clinical features of manic episode
⁕ Main symptoms: mood elevated during a manic episode that
manifests as euphoria, excitement and overjoyed or irritable 
⁕ Common symptoms are:
- Inflated self-esteem or grandiosity: the patient elevates himself
to normal 
- Decreased need for sleep: reduced need for sleep in most
- Talking a lot, talking fast: patients often have pressure to
speak, their voices are loud, speak fast and when they say it is
difficult to stop them.
- Excessive fun: the patient always shows an overly happy
attitude to any phenomena that occur around [7
- Quick thoughts: the patient's thoughts may increase rapidly, but
these thoughts are still interconnected.
-Distractibility: patients are easily distracted by stimuli that are
not important .
- Increasing preferred activity: patients often increase excessive
activity for a purpose such as occupation, politics, religion 
1.2. Crime in subjects with mood disorder
Modestin J. (2002) studied 179 male and 99 female subjects
with mood disorder in Switzerland, showing that 37% of male
subjects had brief or recurrent depressive episodes, the rest were
depressive episodes. Among these people, 40% of men and 7% of
women have committed criminal acts .
Shaw J. et al. (2006) suggest that people who are depressed at
the time of the crime have never been treated .
According to Swanson J.W. et al. (1990), violence reported by
patients was five times more severe in people with depression,
bipolar disorder and schizophrenia than in people without mental
In Vietnam, there have not been many studies on the crime
situation in subjects with affective disorder .
1.2.3. Crime characteristics in mood disorder
220.127.116.11. Crime characteristics in the depressive episode
⁕ Violent behavior
About 1 in 6 depressed subjects have committed suicide, but
only 6 / 100,000 have violent behaviors against others. Often the
victim is family members like wives and children .
According to Sadock B.J. (2007), depression and homicide are
uncommon (annual rate of 0.2 to 0.3/100,000 people/year), victims
are often female partners .
⁕ Murder and then suicide
Murder and then suicide often involves depression. The study
showed that 75% of the killer’s subjects were depressed at the time of
the crime .
⁕ Killing children
Mothers who kill children often have two types, mothers who
kill infant often suffer from psychosis and The mother was identified
as severe depression, they commit high suicide behavior after
committing child murder .
18.104.22.168. Crime characteristics in manic episode
⁕ Violent behavior
Some studies show that less than 50% of people with bipolar
disorder have a history of violent behavior .
⁕ Serious crimes
The subjects with manic episode also committed very serious
offenses, such as causing death by driving in danger, fire and rape
1.3. Some related factors, promoting offense in mood disorder
1.3.1. Sex and age
A study in the United States for more than 22 years found that
10% of women and 0.3% of male offenders were diagnosed with
affective disorder .
1.3.2. Substance abuse and environmental impact
The more people abuse alcohol and drugs, the more likely they
are to commit violence.
SUBJECTS AND METHODOLOGY
2.1.1. Characteristic of the subjects
Subjects of the study included 83 subjects diagnosed with
affective disorders with criminal offenses, in the ages of 20 - 69 years
old, sent to criminal procedure agencies for monitoring, inpatient
treatment and psychiatric forensic assessments from February 2012
to January 2018. The study was conducted at Bien Hoa national
Institute of Psychiatric Forensic Medicine
2.1.2. Selection criteria
+ Research subjects meet the diagnostic criteria for affective
disorders according to ICD - 10 under the following items: F30, F31,
F32 and F33
+ Subjects to be examined by the criminal procedure agency
such as the Police, Procuracy and Court.
+ The appraisal request documents provided by the criminal
procedure agency must be clearly recorded and full of information
about illness and crime.
2.1.3. Exclusion criteria
Not included in the study group of subjects with severe general
medical condition such as heart failure, liver and kidney dysfunction,
dementia who are unable to cooperate in research.
Not included in the study group of subjects with mood disorder
due to a general medical condition and substance-induced mood
disorder, mixed anxiety and depressive disorder.
2.2. Study method
2.2.1. Study design
+ Using the prospective descriptive method, combining
retrospective with the study of documents provided by assessment
agencies, personal and family history of the subject.
+ Analysis of clinical symptoms of mood disorders, nature and
factors related to criminal acts.
2.2.2. Study sample size
The sample is calculated by the formula:
p (1 – p)
n = Z 1 – α / 2 -----------d2
n: sample size is calculated.
z: limited reliability coefficients: z values relating to the
determination of the level of trust, so in this study chose the
confidence level is 95%, then the value of z is 1,96.
α: probability of error type 1
p: is the percentage of previous studies according to Fazel S.
(2002), Nguyen Van Tho (2009), we chose p = 0.25 , .
d: desired accuracy (tolerance), choose d = 0,10.
Instead of the formula we have:
n = --------------------- = 72.03
Thus the minimum sample size is 73 objects. The research team
selected 83 subjects.
2.3. Data processing method
- The data were analyzed by SPSS Version 20.
- The results are presented by Tables and Charts.
2.4. Ethics in research
The research data are kept confidential. The objects does not
have to pay any extra cost in the research process.
CHAPTER 3: RESULTS
3.1. The general characteristic of the research subjects
Figure 3.1. Sex of the research subjects
The figure 3.1 shows that the number of people with mood
disorders in men is 63.86% and women account for 36.14%. This
difference is statistically significant with p<0.05.
Table 3.1. Age group of the study subjects.
The results in Table 3.1 show that the age group from 20-29
years old accounts for the highest proportion (33.73%), followed by
the age group 30-39 years, accounting for 25.30%. The average age
of men is 34.47 ± 10.96 years and women are 42.17 ± 11.53 years.
3.2. Clinical features of mood disorders
Table 3.7. The episodes of mood disorders
Table 3.7 shows that the depressive episode accounted for high
proportion (83.13%), the manic period accounted for a small
proportion (16.87%). Comparison found that the difference was
statistically significant with p<0.01 (Biomial = 69.00).
3.2.1. Clinical features of subjects with depressive disorder
Table 3.9. Main symptoms of depressive disorder
Markedly diminished interest
Loss of energy
Table 3.9 shows that the depressive mood account for the highest
proportion (98.55%), loss of energy accounting for 85.51% and
markedly diminished interest in everything (75.36%). Comparison
showed that the difference was statistically significant (p<0.05).
Table 3.10. Common symptoms of depressive disorder
Diminished ability to concentrate
Feelings of worthlessness
Excessive or inappropriate guilt
Suicidal ideation suicide attempt
Decrease in appetite
Table 3.10 shows that sleep disorders account for the highest rate
(100%), loss of appetite (94.20%), diminished ability to concentrate
(60.87%), feelings of worthlessness (57.97%), suicidal ideation and
suicide attempt (56.52%). Comparing the above data, the difference
is statistically significant (p<0.01)
Table 3.13. Halucinations in subjects with depressive disorder
The results of table 3.13 shows that, 84.21% off subjects with
depressive disorder have auditory hallucinations.
Table 3.15. Thinking disorder in subjects with depressive
Feelings of worthlessness
Recurrent suicidal ideation
Delusion of inappropriate guilt
Delusion of persecution
Delusion of jealousy
The results of table 3.15 show that the feelings of worthlessness
accounted for the highest rate (57.97%). There is recurrent suicidal
ideation occupied (56.52%). Delusion of persecution accounted for
14.49%. The comparison was statistically significant with p<0.01.
3.2.2. Clinical features of subjects with manic episode
Table 3.25. Symptoms of manic disorder
Flight of ideas
Thoughts are racing
Excessive involvement in
Decreased need for sleep
Inflated self-esteem or grandiosity
10 Sexual indiscretions
The results of table 3.25 show that the increase activity, flight of
ideas, decreased need for sleep in all subjects (100%), expansive
mood are very high (92.86%), thoughts are racing (71.43%). The
difference was statistically significant with Cochran's Q test, p<0.01,
χ2(9) = 75.729.
Table 3.28. Thinking disorders in subjects with manic episode
1 More talkative than usual
2 Thoughts are racing
3 Flight of ideas
4 Inflated self-esteem or grandiosity
5 Delusion of grandiosity
6 Delusion of persecution
Table 3.28 shows flight of ideas (100%), more talkative than usual
(85.71%) Thoughts are racing (71.43%), delusion of grandiosity
(50.0%). The difference is statistically significant with Cochran's Q
test, p<0.01 χ2(5)=40.00.
3.3. Characteristics of criminal acts in research subjects
Table 3.31. Offences in the subject with mood disorder
Deliberately inflicting injury
Murder and suicide
Causing trouble in public
The results of table 3.31 show that the homicide and deliberately
inflicting injury accounted for the highest percentage (16.87%),
followed by acts of robbery (10.84%), subsequent acts of murder and
suicide (9.64%), theft (7.23%).
Figure 3.7. The place where the crime occurred
Figure 3.7 shows the largest number of cases in the community
living area (54.28%), followed by the surrounding area (25.30%).