Fast Five Quiz: Homicidal Ideation

Stephen Soreff, MD


August 12, 2022

Conduct disorder is one of the most difficult and intractable mental health problems in children and adolescents. It involves numerous problematic behaviors, including oppositional and defiant behaviors and antisocial activities (eg, physical violence, lying, stealing, running away, sexually coercive behaviors). A recent study found that, although pediatric homicidal ideation is rare, conduct disorders conferred 1483% increased odds.

In addition to the just noted conduct disorder, homicidal ideation has been associated with two personality disorders: narcissistic personality disorder and antisocial personality disorder. Schizophrenia and schizoaffective disorder have also been linked to increased violent and homicidal thoughts. Violence in these conditions can be linked to command hallucinations (eg, voices telling an individual to kill, paranoid delusions). In all of these noted diagnoses, the person's need for an immediate response to their demands triggers frustration and rage, leading to threatening behavior. The connection between mood disorders like depression, various anxiety disorders, and intellectual development disorders and homicidal ideation is less well-established or understood.

Learn more about conduct disorder.


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