_:P_,a psyc2J
a
tlmt tile
not
_®
dangero_
FRO5[
tt.seand.
THE
7{O, 8up?l.
DEPARTMENT
COPENHAGEN.
HEAD:
OF
180_
}89-395
:PSYCtIIATRY)
OVERL-EGE
DR.
(1964).
FREDERIKSBERG
3IED.
EINAR
LSD 2365
,_J:
ttOSI'ITAL)
GEERT-JORGENSEN.
_der the correct
, Chief Pilysic[an_
,s Nervesanatoriutla
HOMICIDE
AFTER
LYSERGIC
Knud
In an article
about
TREATMENT
ACID
WITH
DIETHYLAMIDE
Knudsen
Lysergic' Acid Diethylamide
Dr. I{. A. SA,xmsox
and I. D.A.
WmT_,:L,tW mention, that they ill many patiel\ts
have
observed
enhanced
initiative
emotionality
and aggressive behaviour
after treatment
with LSD.
A ease history is produced
third day after LSD-treatment
about a 25-year old woman,
committed
homicide.
No disl)ositions for mental diseases
patient has grown up in a solid pietistic
She has a three years ymmger
him and the rest of her family.
who on the
.
in her family are known. The
labour environment
in a village.
brother.
She has good relations
with
She visited a council school in the country. After this the 1)atient
had various domestic jobs and was popular there. She was in her native
place considered a healthy and in every respect natural young girl.
She has had no erotic experiences, did not smoke and only very seldom
drank alcoholic liquors and in very small amounts,
until not quite 20
years old she went to Norway as a domestic servant in Oslo. Ostensibly
she bad two male friends with whom she had intimate
relations during
herstayin Norway.
She got a Danish girl friend, Kirsten, who got engaged to the later
murdered Kai. He had a_ illicit still and led the girls into abuse of
alcohol and visits to restaurants.
At a certain time the patient helped
her girl friend in a primitive attempt at a procured abortion, l(ai surprised
them
and later
Not to be published
outside
on repeatedly
the medical
threatened
to inform
the police
press.
389
if the patient would not hal I) him. Later on he was arrested
of theft and made her smuggle out some letters,
It has not been possible
'
to get out details
about
her stay
on a charge
in Norway
but the patient
gradually
got mixed up in considerable
dissipation,
where injections
were given presumably
of stimulating
remedies
or
sedatives.
She thought
that she at any rate at a certain period has got
morphia. As she thought that life had become too complicated she
got many self-reproaches
as to the life she had become mixed up with,
she went to ])enmark but two days after her arrival in a tense and
unbalanced
state she was sent to the mental hospitals
in the towns
of Aarhus and Viborg from where she was discharged in November
1959 and sent to a folk high school. (diagnosis: psychopathic personality?
drugaddiction?)
During the Christmas
holidays she went to her friends Kirsten and
•'
Kai, who now had got married and lived in Copenhagen,
as she did
not like to go to her parents because she was ashamed of her behaviour
in Norway and her two removals to a hospital. During her girl friend's
removal to a hospital Kai made her drunk, had intimate relations
with her and gave her injections.
Pregnancy
was proved in the montk
of February.
She was very doubtful as to the carrying through of her
pregnancy,
but there was psychiatric
indication
for abortus provoeatus
,
enter on inti
and forces hc
Sound
with
about. He p
boy friend a
She move
and has vari
ske saw him
to a girl friez
look her up
other things
under her be
is sentto Fr
She stayed i
from hospita
She allege_
selfreproaehe
hospital,
and
she was at t;
Her state
and she was after the intervention
again sent to the Mental hospital
ia the town of Viborg for three months in the same state of mind as
by the previous removals to a hospital. (diagnosis: psychopathic personality?-- drug addiction?)
After her discharge from hospital she went to Copenhagen as a hospital orderly. She had only been for three weeks in the job when after
open and co,
As we got th
after her sta;
and adaptabl
contained am
her with LSI:
There is a ]
It eonclud(
having gone to see Kai and Kirsten
she learned that he in the face of
others had accused her of having stolen 25 pounds,
She got drunk and was sent to detention and on that occasion the
idea struck her that he ought to be killed. At that time the patient for
the first time is removed to Frederiksberg Hospital.
She was sent to hospital for five days under the diagnosis: "Psychopathic personality (Vacillation). Addiction to alcohol." She was sent to
positive. The
pressive
glee
energy. Her
A strong feeli
ments. Her ]
very doubtful
of working of
hospital in a drunken depressed state. During the few days she was in
hospital she was very taciturn,
sulky, and annoyed, somewhat
self-reproaehful and did not want a longer stay or treatment,
there are pre
patient is mu
tions to other
During the time from :February to June 1961 she is often rung up
or looked up by KAI who ostensibly presses her to lend him money and
sion hampere(
being obvious
390
_d on a charge
enter ou intimate relations. He wishes to have an illicit still in her room
and forces her to accompany
all old acquaintance
from Norway across the
ay in Norway
[e dissipation,
remedies
or
Sound with a bag, the conten_ of which she did not know anything
about. Hc presses her to do so by threatening
to tell her quiet steady
bo b, friend about her past in Norway.
)eriod has got
_plicated
she
.ixcd up with,
t a tense and
in the towns
in November
She moves several times to escape him, starts on evening lessons
and has various jobs, but he looks her up several times. The last time
she saw him was i_ September
1(.)6.1 and October the 1st she moved
to a girl friend's flat. She was always in a state of anxiety that he might
look her up and shunned
human society and was paranoyed.
Among
other things when coming home she would look into the wardrobe and
c personality?
under her bed, whether he was there. For the second time the patient
is sent to Frederiksberg
Hospital on the twenty-third
of January
1962.
She stayed in hospital for 8 months. Immediately
after her discharge
from hospital on April 27 the homicide was committed.
She alleged to have suffered from 4 or 5 periods of depression and
Kirsten
and
a, as she did
mr behaviour
r girl friend's
tare relations
in the month
trough of her
ts provocatus
:ntal hospital
e of mind as
mpathic
per-
_eu as a hosb when after
the face of
occasion
the
e patient
for
_is: "Psycho'_was sent to
s she was in
_hat self-re_en rung up
• money and
selfreproaches
during the 15 months
from her first removal
to the
hospital,
and as it was thought
that she had endogenous
depression
she was at the beginning treated with 8 Narco-curare-electroshock.
Her state of mind became somewhat better and she became more
opcn and cooperative,
but still was shy and much contacthampered.
As we got the impression that the psycho-traumatic
events during and
after her stay in N or_ay had ehanged her from a robust industrious
and adaptable
girl into a hampered,
shy,
contained and inadaptable
girl we thought
her with LSD-treatment.
depressed,
distrustful,
selfpossibly to be able to help
There is a Rorschach-test 4 days after the second removal to hospital.
It concludes: Even if the contact is rather weak yet the accept is
positive.
pressive
The patient produces
32 replies.
gloom but there is no peculiar
Her state
depressive
is marked by deenfeeblement
of
energy. Her gifts are somewhere in the uppermost
half of the average.
A strong feeling of insufficiency
can influence the intellectual
achievements. Her personality
is much introverted,
emotional
and touchy,
very doubtful with tendency to sensitivity. The extrovert possibilities
of working off are very narrow, the powers of contact are rather weak,
there are predispositions to accumulation of passion. At present the
patient is much absorbed
in conflict-filled
speculations
about her relations to other people. She seems to fix feelings of resentment,
is aggression hampered and her conception of men has a paranoid note without
being obviously paranoid. Besides there is a certain uneasiness.
391
Conclusion
soon
calmed
do
Her gifts are somewhere
in the ul)permost
half of the average. Her
state is marked by depressive gloom but without weakness of energy.
Besides there is anxiety, a certain sinister feeling and tendency to paranoid coloured opinions,
]?crsonality is sensitive without
confidence in herself, very emotional
and sensitive,
aggressive state_
On the followi
on the third da
To a high
degree
extrovert
possibilities
of working
off are
missing.
habitual
state,
she was to go tq
job as a visitin_
return to tell h(
Immediately
:Before the LSD-trcatment
we knew that
whom we have mentioned
before.
she was dependent
on Kai,
that she was re
One hour an(
given,
The patient
with a week's
of Eastern,
received
interval,
was given
a total of 5 LSD-treatments
which were given
apart from the last treatment
which because
at an interval
of a fortnight.
that
she
of Fine Arts an
she came back1
During
Each time she got 50 gamma LSD. During the first four treatments
she was very self-contained, depressed and self-reproachful and difficult to contact.
She only came with a few desultory
remarks. Her behaviour
during
the first treatmcnt
showed many traces of passion,
where she scratched her wrist. Sometimes she was aggressive when
l
the f(
pital and later (
stated that, to
treatment,
she
It was as if she
Besides, it w_
mentioning the later mm'dercd ](ai and during the second treatment
she, among othcr things, cried: "Go away Kai, I don't want to Kai,
I kill you!" She was rather exhausted
after the treatments,
lying drowsy
in bed the following day. On the third day after the treatments nothing
by some fellow
• morning before
patients
and tt
behaviour.
remarkable
in the ward was to bc observed, and she obviously felt well.
])uring the last LSD-trcatment
on April 25, she got l{itMin in order
to gct her out of her hampered
state, she said when being given the
injection:
"Kai pricked too". Thereafter
she was very unstable, crying,
After having
was in vain, if I
a taxi-cab
to t
to see Kai. lie
and one moment she indicated that she desired to kill Kai while lookil_g
they returned t
at her hands
of what
and saying
that
they
could
be used to so many
purposes
-- the next moment she folded her hands and was self-reproachful,
She indicated
that the doctor's face now and then assumed the shape
of that of Kai. J)uring the last four treatments
she was placed in a belt
because of her motorious
agitation
and her primitively
attempted
suicide
while being treated.
During the last treatment
she was released from
the belt and broke a few panes. She had to get hypnofen and after that
she came into an excited state in which she broke a chair,
In the afternoon she fell asleep on medicine. About 11 p.m. she woke
up and was restless
392
and desperate,
she threw
a cup on the floor but was
had
ha
complete void i
with her, on ex
on her garment:
while she grasp.
Then she remel
had the knife i_
that she was s(
During the fi
depressed
and c:
soon calmed
down and when talking
with
her, she did not make
any
_'erage. Her
of energy.
tcy to para-
aggressive statements
as to Kai.
Oa the following day she was very drowsy, quiet, and unobtrusive
and
on the third day, the day of her discharge,
she seemed to be in her
habitual
state, although
somewhat
depressed.
It was thought
that
g emotional
she was to go to the Health ]insurance Society, in order to apply for a
job as a visiting woman assistant, there -- and later in the day was to
Lre missing,
return to tell how she had got on.
Immediately
before leaving the Ward at about
_nt on Kai,
11,30 a.m. she indicated
that she was restless arid would like to throw something
on the floor.
One hour and a hMf after she had left the ward, information
was
given, that she had stabbed
a man with a knife at the RoyM Academy
were given
[chbecause
of Fine Arts and through the ca_uMty ward of the 5Iunicipal hospital
she camebackto the ward.
treatments
I and diffiks. Her be-
During the following mental observations
at the Frederiksberg
Hospital al_d later o_1at the psychiatric ward of the National Hospital she
stated that, to a certain degree, still under the influence of the LSI)treatment, she had felt confused and labile, when leaving the ward.
of passion,
ssive when
It was as if she had been beside herself.
Besides, it was informed, that she, without
• treatment
mt to Kai,
'ing drowsy
nts nothing
by some fellow patients in the ward but had controlled herself. On the
morning before the discharge
the patient had taken leave of the other
patients
and the staff had not observed
anything
remarkable
in her
behaviour.
ly felt well.
[in in ordex"
given the
ble, crying,
bile looking
After having come home to the flat, she got the idea that everything
was in vain, if Kai did not get away. She put a knife in her pocket, took
a taxi-cab to the Royal Academy of the Fine Arts, where she went
to see Kai. He took her to a pub, where they had a few drinks. Then
they returned
to the Academy
where Kai was employed.
Her memory
_y purposes
eproachful,
the shape
_.din a belt
}ted suicide
eased from
l after that
of what had hapl)ened there is only fragmentary and influenced by a
complete void in her memory. She is of opinion that Kai had coition
with her, on examination, however, no signs of sperm had been found
on her garnlents.
She is of opinion too that he put his head on her lap
while she grasped the handle of the knife she had in her shoulder bag.
Then she remembers that Kai lay upon her. She is of opinion that she
had the knife in her hand and grasped the blade. She then remembers
that she was screaming and that a lot of people came in.
. she woke
,or but was
During the first days after the homicide the patient
was apathetic,
depressed and crying now and then. Several times she indicated thoughts
reason,
had been irritated
393
:
::
:
:
"
!
of suicide. On the basis of the doctor's certificate of her state of mind
from the Psychiatric Department of the National Hospital the Medicolegal Council states among other things: that the abnormal mental
components which are supposed to have manifested themselves in the
patients psyche at the moment of action are connected with the fact
that since the age of twenty she apparently has had certain symptoms
of charaeterological insufficiency -- by way of introduction of the abuse
of drugs and alcohol and in the following years with a more permanent
reduction of the mental resistance an inclination to react with depressions, lack of self-confidence and irresoluteness even to slight outward
strain.
and this seJ
department
provoking I
continued w
8a._D_SOX,
I_,
of Lyre,
Under the possibly ambivalent -- but at any rate very straining
relations with Kai there is developed a reactive, anxious-depressive
state
coloured by an abnormal prospensity to self-importance which at any
rate during the last six months before the homicide, dominated her
to such a degree that it must be regarded as having been of psychotic
nature, a depressive -- psychogenic psychosis -- lasting mainly unchanged from September 1961 until the events on April, 27, 1962.
In this mentally delicate person the LSD-treatment
have activated
to an exceptional degree already existing aggressive impulses and
incitements together with the fact that it has weakened the inhibition
and selfcontrol of the accused. Thus it must be assumed that the treatment has decisively influenced the faculty of the accused for self-control
_nd control of aggrcs_iv0 irnpulse_ -- including the motive to killing
Kai
As to the amnesia of the accused concerning the action of killing
itself that must be supposed to be due to an effectively conditional,
psychogenic repression Her detailed memory of the course of event
on the day in question until the moment of homicide makes it unlikely
that amnesia is caused by a disturbance of consciousness existing at
that moment
The patient was recommended to be sent to a mental hospital
This report is in accordance with the opinion of Overl0ege Dr med
EI_'AI_ GEERT-J6RGENSEN
expressed in his certificate of her state of
mind in which as to the influence on her action the following is stated:
"I do not think that the patient on her discharge has been under the
toxic influence of LSD. On the other hand I dare not rule out that the
LSD-treatment
has diminished certain restraints which she had previously been in possession of.
Cases of homicide after LSD-treatment
are not known in literature
394
Discussion:
-i ¸
i/
:ate of mind
and this serious complication
the Medico:mal mental
_elves in the
"ith the fact
dcpartment
concerning the LSD-treatment,
but because of thoughtprovoking
positive
results with other patients
the treatment
will be
continued with this drug.
n symptoms
of the abuse
e permanent
with depresghtoutward
has sharpened
the safety valve of the
l_cferences
'
_A.xmso:,-,R. A. & I. D. A. "_VIIITELA'_V
1957): Further Studies in the Therapeutic Value
of Lyserglc Acid Diethylamide in Mental Illness. J. Ment. Sci. 103, 431.
K. P. KNUDSEI_',
M.D.
ry straining
Frederiksberg
Copenhagen
,ressivc
state
dfich
at any
Denmark
minated
her
of psychotic
mainly ua7, 1962.
ve activated
Discussion:
See under
ALNrES,
Hospital
R!
npulscs and
he ir hibition
at the treatr self-control
Ce to killing
)n of killing
conditional,
rse of event
_s it unlikely
existing
at
)spital.
,ge Dr. reed.
her state of
ng is stated:
;n under the
outthatthe
he had prein literature
395
'