PSYCHIATRIC ASPECTS OF RUNNING AMOK (GOIN G BERSERK)

We performed a content analysis study based on 196 reports in the Germ an press published during the last decade on acts of violence designat ed as ''going berserk'' or ''running amok (amuck)'' and meeting define d criteria. With less than one person per one million men per year run ning berserk or amok, this is a very rare act of violence, albeit a ve ry dangerous one involving 1.3 deaths and 1.7 injuries per case. Offen ders differ from the normal population in regards to the small percent age of women (5 %) and high unemployment (40 %), and from other violen t offenders in that they are normally occupationally well-qualified. S evere psychiatric disorders are overrepresented. A total of 108 cases were classified according to specific syndromes either by specialists or experts on the spot, or on the basis of a description of the signs and symptoms. Of the syndrome-related acts, the most dangerous offence s were committed by 10 delusionally ill and 2 psychopathic individuals . 30 less dangerous offenders suffered from paranoid-hallucinatory syn dromes. 28 crimes committed in a state of intoxication and 11 ''crimes of passion'' were the least dangerous. Another 25 persons with an ext ensive incidence of suicide in the family, without any apparent pre-ex isting psychiatric disorder, may have gone berserk in the course of a depressive syndrome. Although psychotically ill individuals tend to ov erreact more often following a minimal slight, under delusions or with no apparent reason at all, on the whole the causes for both the psych otic and other offenders are of a serious nature. Object loss and priv ate disputes on the one hand and social conflicts on the other were of approximately equal significance. The relationship between the offend er and his victim is more essential for the course of the occurrence t han motives or the type of the psychopathological syndrome. If only fa mily members are attacked, the offenders have usually been inconspicuo us, elderly individuals, two thirds of whom can not be allocated to a given syndrome and may be depressive. They kill deliberately and on-ta rget, do not merely injure their victims - hardly ever, in fact - and then commit suicide practically without exception. If strangers are th e target of violence, the crimes are generally committed by younger, p assive-aggressive, psychopathic, paranoid or intoxicated offenders. Th ey kill only about half of their victims, but injure many, also causin g a great deal of damage. They rarely commit suicide. Between these tw o extremes we have highly dangerous and diagnostically widely differen t offenders, half of whom cannot be allocated to a definite syndrome a nd who attack friends or strangers besides their own family and subseq uently commit suicide in apparently one third of the cases. These resu lts complement previous concepts usually derived from single-case stud ies of persons going berserk or similar phenomena in industrialised na tions, and place them in a new perspective.