0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letter to the Editor   |    
Dr. Spinelli Replies
MARGARET G. SPINELLI, M.D.
Am J Psychiatry 2002;159:499-499. doi:10.1176/appi.ajp.159.3.499

To the Editor: Dr. Mendlowicz and colleagues describe findings derived from their "archival" study of neonaticide (1900–1995) "cases identified retrospectively through a search in the judicial files of the city of Rio de Janeiro" (Mendlowicz et al., 1999; reference 1). They hypothesize that the increase over time in reports of amnesia in their series was a result of a change in Brazil’s legislation, which provided mitigation for psychiatric symptoms in cases of neonaticide. They ascribe these reports to malingering. The authors suggest that the amnestic symptoms reported in my case series were also due to malingering and assert that the Dissociative Experiences Scale provided a psychiatric checklist as an alibi for the defendants (2).

The Dissociative Experiences Scale is a screening tool for general dissociative psychopathology as it appears in daily life circumstances, not merely at the time of pregnancy or childbirth. Amnesia is one factor among several in the Dissociative Experiences Scale. Spontaneous reports of amnesia in my study group focused on the time of delivery and viewing of the infant. The Dissociative Experiences Scale cannot preclude the possibility of malingering when secondary gain plays a pivotal role. Even so, I reported that two abnormally high scores in my study group suggested malingering. Nevertheless, Mendlowicz and colleagues raise the important issue of methodology.

A preponderance of the literature on neonaticide is derived from judicial statistics or retrospective chart reviews that have used varied and outdated diagnostic criteria (3). Contemporary reports of case interviews describe psychopathology similar to that reported in my study group (4, 5). One cannot infer cause and effect from a temporal relationship nor compare archival data derived from varied sources to contemporary interviewer data.

I addressed the lack of a malingering tool when I discussed the limits of my data. This accepted method of reporting suggests that the reader arrive at his or her own professional opinion given those limitations.

In appreciation of the authors’ concerns, I restate the purpose of my preliminary work. The vital need for further study of neonaticide should encourage inquiry and prompt phenomenological studies using structured interviews and contemporary diagnostic criteria. Once psychopathology is identified, strategies for treatment and prevention can be devised.

Mendlowicz MV, Rapaport MH, Mecler K, Golshan S, Moraes TM: A case-control study on the socio-demographic characteristics of 53 neonaticidal mothers. Int J Law Psychiatry  1998; 21:209-219
[PubMed]
[CrossRef]
 
Steinberg M, Rounsaville B, Cicchetti D: Detection of dissociative disorders in psychiatric patients by a screening instrument and a structured diagnostic interview. Am J Psychiatry  1991; 148:1050-1054
[PubMed]
 
Resnick PJ: Murder of the newborn: a psychiatric review of neonaticide. Am J Psychiatry  1970; 126:1414-1420
[PubMed]
 
Bonnet C: Adoption at birth: prevention against abandonment or neonaticide. Child Abuse Negl  1993; 17:501-513
[PubMed]
[CrossRef]
 
Green CM, Manohar SV: Neonaticide and hysterical denial of pregnancy. Br J Psychiatry  1990; 156:121-123
[PubMed]
[CrossRef]
 
+

References

Mendlowicz MV, Rapaport MH, Mecler K, Golshan S, Moraes TM: A case-control study on the socio-demographic characteristics of 53 neonaticidal mothers. Int J Law Psychiatry  1998; 21:209-219
[PubMed]
[CrossRef]
 
Steinberg M, Rounsaville B, Cicchetti D: Detection of dissociative disorders in psychiatric patients by a screening instrument and a structured diagnostic interview. Am J Psychiatry  1991; 148:1050-1054
[PubMed]
 
Resnick PJ: Murder of the newborn: a psychiatric review of neonaticide. Am J Psychiatry  1970; 126:1414-1420
[PubMed]
 
Bonnet C: Adoption at birth: prevention against abandonment or neonaticide. Child Abuse Negl  1993; 17:501-513
[PubMed]
[CrossRef]
 
Green CM, Manohar SV: Neonaticide and hysterical denial of pregnancy. Br J Psychiatry  1990; 156:121-123
[PubMed]
[CrossRef]
 
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Books
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 33.  >
APA Practice Guidelines > Chapter 0.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 34.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 33.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 12.  >
Topic Collections
Psychiatric News
PubMed Articles