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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.. . [8], [9]. It is these disease-causing genes that are pa

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.. . [8], [9]. It is these disease-causing genes that are pa

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from generation to generation, which makes depressive disorder of

family nature.

⁕ 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 [6].

1.1.2.2. 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 [40].

⁕ 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 [24], [59].

1.1.3. Clinical features of mood disorder

1.1.3.1. Clinical features of depressive episode

⁕ Main symptoms

+ depressed mood must present for most of the day and almost

every day

+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.. [62]

⁕ 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



4

+ 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 [4]

+ Bleak and pessimistic views of the future

+ Ideas of guilt and unworthiness: Depressed patients have

negative views about the world around them and themselves [61]

+ 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

1.1.3.2. Clinical features of manic episode

⁕ Main symptoms: mood elevated during a manic episode that

manifests as euphoria, excitement and overjoyed or irritable [61]

⁕ Common symptoms are:

- Inflated self-esteem or grandiosity: the patient elevates himself

to normal [4]

- Decreased need for sleep: reduced need for sleep in most

patients

- 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 [79].

- Increasing preferred activity: patients often increase excessive

activity for a purpose such as occupation, politics, religion [4]

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



5

depressive episodes. Among these people, 40% of men and 7% of

women have committed criminal acts [90].

Shaw J. et al. (2006) suggest that people who are depressed at

the time of the crime have never been treated [91].

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

illness [92].

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

1.2.3.1. 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 [3].

⁕ Homicide

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 [24].

⁕ 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 [113].

⁕ 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 [119].

1.2.3.2. Crime characteristics in manic episode

⁕ Violent behavior



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Some studies show that less than 50% of people with bipolar

disorder have a history of violent behavior [104].

⁕ Serious crimes

The subjects with manic episode also committed very serious

offenses, such as causing death by driving in danger, fire and rape

[3].

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 [121].

1.3.2. Substance abuse and environmental impact

The more people abuse alcohol and drugs, the more likely they

are to commit violence.

CHAPTER 2

SUBJECTS AND METHODOLOGY

2.1. Subjects

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



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+ 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)

2



n = Z 1 – α / 2 -----------d2

n: sample size is calculated.



8

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 [100], [130].

d: desired accuracy (tolerance), choose d = 0,10.

Instead of the formula we have:

1,962 (0.25.0,75)

n = --------------------- = 72.03

0.1 2

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.



9

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.

Patients



n



%



20-29



28



33.73



30-39



21



25.30



40-49



20



24.10



50-59



10



12.05



>59



4



4.82



Age group



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.



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3.2. Clinical features of mood disorders

Table 3.7. The episodes of mood disorders

Statistical index

No.

n=83

%

p

Episodes

1

Manic episodes

14

16.87

p<0.01

2

Depressive episodes

69

83.13

Total

83

100.00

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

Statistical index

No.

n=69

%

p

Symptoms

1

Depressive mood

68

98.55

Markedly diminished interest

52

75.36

2

p<0.05

pleasure

3

Loss of energy

59

85.51

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

Statistical index

No.

n=69

%

Symptoms

1

Diminished ability to concentrate

42

60.87

2

Feelings of worthlessness

40

57.97

3

Excessive or inappropriate guilt

5

7.25

4

Pessimistic

30

43.48

Suicidal ideation suicide attempt

39

56.52

5

attempt

6

Sleep disorders

69

100.00

7

Decrease in appetite

65

94.20



p



p<0.01



11

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

No.



Statistical index

Symptoms



n=19



%



1



Simple hallucination



1



5.26



2



Auditory hallucinations



17



84.21



3



Visual hallucinations



2



10.53



p



p<0.01



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

disorder

Statistical index

n=69

%

p

Symptoms

1

Feelings of worthlessness

40

57.97

2

Recurrent suicidal ideation

39

56.52

3

Delusion of inappropriate guilt

5

7.25

p<0.001

4

Delusion of persecution

10

14.49

5

Delusion of jealousy

3

4.35

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.

No.



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3.2.2. Clinical features of subjects with manic episode

Table 3.25. Symptoms of manic disorder

Statistical index

No.

n=14

%

p

Symptoms

1

Expansive mood

13

92.86

2

Increase activity

14

100.0

3

Flight of ideas

14

100.0

4

Thoughts are racing

10

71.43

Excessive involvement in

4

28.57

5

pleasurable activities

p<0.01

6

Decreased need for sleep

14

100.0

7

Inflated self-esteem or grandiosity

4

28.57

8

Distractibility

8

57.14

9

Foolish behavior

3

21.43

10 Sexual indiscretions

1

7.14

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

Statistical index

No.

n=14

%

p

Symptoms

1 More talkative than usual

12

85.71

2 Thoughts are racing

10

71.43

3 Flight of ideas

14

100.00

p<0.01

4 Inflated self-esteem or grandiosity

4

28.57

5 Delusion of grandiosity

7

50.00

6 Delusion of persecution

1

7.14

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.



13

3.3. Characteristics of criminal acts in research subjects

Table 3.31. Offences in the subject with mood disorder

Statistical index

No.

n=83

%

p

Offences

1

Deliberately inflicting injury

14

16.87

2

Homicide

14

16.87

3

Murder and suicide

8

9.64

4

Theft

6

7.23

p<0.01

5

Robbery

9

10.84

6

Causing trouble in public

1

1.21

7

Other offences

31

37.35

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%).



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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.. . [8], [9]. It is these disease-causing genes that are pa

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