In a garbage container, the basurers find a sports bag containing the cadaver of a newborn.
The autopsy reveals that this is a live term newborn, female, with signs of postpartum vitality, with the cord and eight hours of cold action and death estimated without other signs of violence, considering the forty date of death produced
A 27-year-old woman is arrested by the police, to whom a clinical-analytical-ecographical study diagnosed a puerperal state of less than 10 days of evolution.
Detention is surprised by the results, denying evidence of recent delivery.
Your partner is not aware of your previous pregnancy.
The clinical history of women highlights childhood and adolescence in a home with an alcoholic father, having witnessed and suffered many clothes and abuses.
She is a single mother at 23 years of age, with great anguish and rejection throughout pregnancy.
A second pregnancy year and a half after the first is lived again with anguish, guilt, rejection and concealment and the delivery takes place at home alone.
The child is then adopted.
The pregnancy (the third) whose result motivates the judicial facts, is the result of their relationship with their current stable partner and triggers the same feelings as the previous ones.
She denies herself; she realizes that something is mute within her, but she forgets it soon; she conceals it from others even from her partner (she had not gained too much weight).
Depressive and suicidal ideas also emerge.
As pregnancy progresses, episodes in which you cannot remember things are frequent.
He realizes that his belly grows, but he doesn't want to accept it, or to assume it.
You have the feeling that giving a tecla changes, and starts to feel worried, fearful, anxious about pregnancy, but then you still live as if you were not pregnant.
It was arrested by the police several days after the newborn was found in the garbage; the young woman knew it was because she had seen him in TV and in the press, but did not know she was the author.
When the police taught him the sports bag where the newborn appeared in the container, he quickly identified it and said: "I have an equal."
In short, he absolutely denied that in the previous days he had given birth and had thrown the product of childbirth into a garbage container.
The following medical-forensic method was used: gynecological and ultrasound examination, with the following findings: a peri-nephric acid, and violet, without tears.
The uterine cervix was narrowed and permeable to one finger with serosanguineous secretion (loquium).
Increased uterus, like 12 weeks (about 12 cm)
Pigmented large breasts, from which a stream of milk secretion comes out under pressure
Endometrial microlegrade was performed for histological study (positive result was obtained from decidual cells).
Ultrasound showed the following uterine measurements: 11.50 cm in length, 7.7 cm in anteroposterior diameter.
Presence of small remnants (loquia) intrauterine.
A genetic profile study of A.D.N., which subsequently confirms the maternity of the inmate in relation to the newborn.
Psychopathology is conscious, wet, time-oriented, space-oriented and person-oriented, collaborating correctly in the interviews.
During this report he describes multiple occasions compatible with crepuscular states or narrowing of the field of consciousness that course with posterior amnesia with partial preservation of the vigil and sense of perplexity "as if he were once in a stage".
Attention and concentration: normal.
Affectivity: she has a depressive mood, with feelings of unhappiness, guilt ideas, low self-esteem, negative thoughts.
Suicidal ideation.
Frequent crying during the interviews, with emotional discharges especially when talking about their parents and facts.
Insomnia.
Anxiety associated with distress that is exacerbated when talking about the facts.
Memory: close memory is within normal limits.
Memory is affected by lacunar amnesias that are repeated for personal information, especially in relation to their pregnancy situations, with some selectivity for the themes of pregnancy.
Thought: the course of thought is normal, with a logical, fluid and harmonic speech and language.
The content of the thought is normal, being a realistic thinking, but presenting no frank delusions or deliroids.
Mild perception: no alteration.
The intellectual level is within the conventional limits of normality.
Other complementary tests: an electroencephalogram (EEG) was performed, resulting in a trace without pathological findings.
The MMPI-2 test was performed obtaining a profile with high scores on the Pa scale (paranoia), Pd (psychopathic deviation), Pt (psicastenia), and Sc (schizophrenia).
Clinical judgments of identity disorder (multiple personality) and depressive mood disorder are issued.
The article reports on the total unimputability of the mentally ill.
The Provincial Hearing condemns her for a crime of murder with an aggravating relative and attenuating factor of incomplete mental alienation to six years of imprisonment to replace, for the same time, for psychiatric treatment on an outpatient basis.
COMMENTS AND FINANCIAL ASSESSMENT
It is evident that multiple personality is a rare disorder, poorly diagnosed or poorly known, and even in some psychiatric settings there is skepticism about its existence [6], stating that this disorder is an artifact of the film or the result of a film.
In fact, in the forensic psychiatry literature the use is generally not dedicated more than one page, emphasizing the rare or uncommon of multiple personality, and the criminal exceptionality [7].
In this case we show that the patient has presented several episodes with a memory void of an indeterminate time, forgetting some facts, but not all; generally, according to the literature, the forgotten period of time is clearly defined.
Most patients are aware of having "lost part of their time", but others have "amnesia of amnesia" and begin to be aware of the lost time only when they face the fact that they do not even remember the fact that they have.
Dictionary is intense until the degree of personality transformation is determined, being evident in the patient at least two different personalities.
Moreover, in relation to their pregnancy situation, they are not able to assume it, it is something that surpasses it, presenting a depressive-type mood disorder that is more evident in one of their personalities.
It was not easy to reach the diagnosis, taking into account other nosological entities such as schizophrenia, borderline personality disorder, and above all simulation, because we were in the presence of a case of murder of a newborn.
Margaret G. Y Spinelli M G. [8] detached the frequency of the relationship between the death of the newborn on the day of birth with the fact of previous denial of pregnancy and the settlement
The symptomatology of identity diversion disorder itself offers the differential diagnosis with the first two (in schizophrenia, if there are several personalities manifest at the same time).
The persistence of symptoms over long periods and numerous interviews with the patient made us reject the simulation [9].
unveiling the existence of each illness and its magnitude in the hospital, psychopharmacological treatment to which it was subjected, and its personal situation in that module penitentiary, make gradually become aware, as multiple elements of
The biographical history (especially the existence of childhood traumatic experiences, as documented in the literature), and the inexistence of another compatible psychic pathology and biological findings led to the diagnosis.
Some authors propose using specific diagnostic instruments such as structured scales or questionnaires such as the Structured Clinical Interview for the Elderly (SCID-D or the Structured Clinical Interview for the Elderly), (1986), Steinstein [12],
For the forensic assessment of multiple personality disorder we conducted the study of criminal psychogenesis according to phenomenological criteria, i.e. interpreting the experiences that explored manifests us [13].
Although we are not facing a psychotic person in the sense of traditional psychiatric nosology we can assimilate the murder of the newborn as a psychotic crime: unpredictable, surprising to those around the author without rational purpose [14].
A lack of emotional resonance or indifference also occurs when the patient becomes aware of the facts, but a depressive emotional state arises.
At the time of the facts, that is, during an indeterminate time in relation to childbirth, as well as in other later periods in relation to it, the intellectual and motor activity of the explored passage was also governed by the conscious personality "for its own other
During the time lapses in which "the other personality" prevails, circumstances similar to the crepuscular states occur, in which the awareness of oneself and the outside world is compromised, as well as self-control.
Indemnity in the person's cognitive and volitional capacity are indispensable premises to be able to assign his/her actions; in our case, there is no capacity in the patient to value the facts based on the right.
Therefore, in the absence of such measures, a person who commits a crime in the course of a divisive identity disorder may not be motivated by a legal norm, and has criminal liability.
It is recommended psychiatric treatment of antidepressant pharmacological type, and psychotherapeutic type, treatment that can be carried out on an outpatient basis.
