Can we diagnose a suspect?

[Errata]

Short answer?
God no. Not even a little.

And I admit, it drives me crazy when people whip out a section of the DSM-IV to assign a disease to someone who lived 130 years ago. There are three major problems to trying to categorize anyone from this remove.

First of all, we can't be sure of the symptoms. We don't know what was observed, what was assumed, what was reported. Mania in 1888 is not mania now. Same word, same general tone, but completely different meanings. And there is an aspect of mental illness that doesn't get a lot of discussion. A good portion of mental illness is cultural. Many symptoms are behaviors that are outside of the cultural norm. Some things remain the same. Cannibalism for instance. Not okay then, not okay now. Many do not. Women enjoying sex was thought to be a symptom of mental illness. Rape was not. Substance abuse was not. Non weapon oriented violence was not. Masturbation of any frequency was considered a symptom of mental illness, as was homosexuality (though lesbianism was legally a myth). It's all cultural, all dependent upon what was considered normal behavior at the time. So any symptom listed might simply be a natural expression, but because it was considered a symptom then, we assume that it refers to some kind of obsession or compulsive excess, when in reality it was perfectly normal.

The second problem is that diagnosing a patient is not simply a matter of Opening the DSM-IV and picking what fits. It is one part science, one part art, and one part sheer luck. Anyone who has been through the mental health evaluation process knows that they will pick up about seven or eight different diagnoses along the way. A lot of things look like a lot of other things. I have been tested for autism nine times. I'm not autistic. My brain works differently, either because it just does, or because I was medicated before puberty and my brain rewired. I was in the running for major depressive disorder, childhood onset bipolar II, anoxia related brain damage, childhood onset schizophrenia, attention deficit disorder, and temporal lobe epilepsy for about 10 years. It wasn't until I was through puberty that they could get accurate scans of my brain to rule some of them out. And after than it was just total guesswork. They treated me for everything I remotely qualified for until they found something that worked, which was Lithium, a bipolar medication. But generally, the decision was based on a very strict interpretation of Bipolar, which states that you only ever need one manic episode to qualify. And I had one. Just one. No doctor upon a single meeting or even having my entire file would have diagnosed me Bipolar. It took years. I have a very atypical presentation. But it is Bipolar. One part blind luck.

Lastly, the only hope we have of a diagnosis for someone we can't observe is a classic presentation. And of course, about half of the people with mental illnesses do not present classical symptoms to their disease. People think "oh delusions. That's Schizophrenia". No. It could be, that's classic. But it could be Bipolar, Mania, PTSD, Anxiety disorders, Substance abuse, OCD, body dysmorphia, Depression, about 12 others. And I can think of about six other causes of delusions that have nothing to do with mental illness. That can happen to anyone. But even with classical presentation, most people don't what symptoms have to be present, or what symptoms have to be absent in order to make an accurate assessment. Delusions and hallucinations without cognitive processing issues is probably not Schizophrenia, no matter how much it looks like Schizophrenia. It is a structural disorder, and a Schizophrenics brain is collapsing on itself. If there is no cognitive deterioration, it's something else. If a person is prevented from doing some ritualized action, like hand washing, and they don't absolutely freak out, it's not OCD. It's just a habit. If a person describes themselves as being intensely sad, they probably aren't depressed. Depression feels like a fog, everything is dull and lifeless, the world is an uninteresting shade of gray. It's the memory of feeling that makes depressed people sad. We weep over it the way someone mourns a lost limb. But we always return to tired, disinterested, unmotivated. Not sad.

So we can't diagnose these people. Should we even try?
Maybe.

In a lot of ways, it matters. A schizophrenic has a timeline that is different from other mental illnesses. It's cyclical, with people coming in and out of delusion. But most importantly, over time they lose executive function. During times of stress, a Schizophrenic is more likely to become less functional, same with OCD, or someone who is depressed. But stress boosts mania, triggers the hyper awareness of PTSD, causes Bipolar people to rapid cycle, giving them more chances to become in fact very alert. Hallucinations can be ignored. It s much harder to fight a delusion. Certain mental illnesses lend themselves better to violence. Some prohibit organized behavior. Some even severely limit life expectancy.

I have said on any number of occasions that I don't think Jack the Ripper was schizophrenic. So for me, identifying a Schizophrenic suspect would take him out of the running. Severe OCD is also an unlikely candidate. No sufferer of OCD would be able to tolerate any interruption of their ritual, and very likely would not leave, even under threat of discovery. Nothing else would matter but finishing what he meant to do.

Me, I can sling around diagnoses all day long. I was a psych major, I've had to work with psychological assessments and profiles for most of my working life, and seeing a shrink for 30 years doesn't hurt. And there are other who have worked in the field who are on this site who have made very coherent assessments of various individuals. I think it's a useful debate. And I think that it's a debate that anyone can join in on, as long as they are willing to learn. I'm not always right. I know some stuff, but I don't know everything. I've been corrected any number of times on any number of subjects. I'm willing to be guided, and I'm willing to let the voices of greater experience shape my opinion. I hope that other will allow me to impart my knowledge.

Basically, I know mental illness. Intimately. And I'm fine. But it doesn't work they way a lot of people think it works. And if you are going to understand a possibly mentally ill suspect or killer, you have to understand the symptoms, possibly the disease, and you have to understand how it works. It's not Jekyll and Hyde. It's not like being wasted. It's not Toon Town (who doesn't love a Roger Rabbit reference?) It's complicated, and it's simple. Binary and infinitely complex. Life altering and a footnote. The brain is a strange and wonderful creation. When it works it's a thing of beauty. When it doesn't, there is also a kind of beauty. If you can put yourself in the shoes of someone with a mental illness, you can see the obstacles that need to be removed, the conditions that have to apply, and the vastly complicated array of emotions that goes with it. It can't be written off as abnormal. It's a different way of being, and they are ways that not only deserve respect, but empathy. If you call someone Schizophrenic, you have to be willing to feel sorrow at the loss of control, wonder at the way personality is expressed even in delusion, respect for moving through one world while living in another. In other words, if you are going to label someone as something that society deems ugly, be willing and able to see the beauty. Because it's always there.

[Mr Stu]

Beautifully written there, if I may say, and so correct on many levels.

[Errata]

Thank you, though I have to confess my intention was not to write beautifully. I think that quite a bit of this mystery is paradoxical. Building a case against a suspect without a shred of evidence. Compiling a victim pool when no two people agree on what the essential feature of a Ripper killing is. Diagnosing a suspect when it can't be done. Determining the veracity of witness with no fact to back them up. It is all fruitless endeavor, and yet it has value. Can we solve the case doing it? I have no idea. Probably not. But our research can add to the body of knowledge of the era. Our observations of behavior could be different enough to challenge what it is we are supposed to look for. We can educate people, even one at a time on issues that affect humanity today. We can elevate, we can reveal, we can turn things upside down, we can learn to think differently. Which to me is far more remarkable than solving a case, even one of such renown.

Through this one case we have the ability to learn about problems that still affect us. Poverty, prostitution, mental illness, domestic violence, all of it. And it is a hard person indeed who can come on this board and argue for justice for the "unfortunates" targeted by Jack, and then see a prostitute on the street of their city and dismiss them as some sort of oversexed addict. We know these women. They weren't "mere" whores. They were people. That changes us. Examining the lives and the behavior of the Whitechapel prostitutes is highly unlikely to lead to a break in the case. But knowing their lives leads to sympathy for anyone who shares their occupation. And I think a thorough knowledge of mental illness can do the same. Someone who knows schizophrenia is not going to back away in fear when they meet one. Someone who understands Bipolar will not sit idly by while people make fun of someone who suffers from it. And no one who even a little gets OCD will taunt someone with the disorder by purposefully triggering their rituals. And yes. A thorough understanding of what people in asylums or on the streets faced is unlikely to produce the killer. But it's not impossible. And more importantly, it lets people argue with knowledge about mental illness, and it creates compassion. This case is, for many, an intellectual exercise. But it can be uplifting if we treat all of the facets of this time period with respect, and strive to learn the truth. Not just their truth in 1888, but the truth now, and the truth that doesn't change.

Or to put it in a very simple way, any one of us on these boards can give a bunch of reason why a prostitute does not deserve scorn. But for the mentally ill, if I take away the option of responding that they do not deserve scorn because it isn't their fault they are sick, how many people can come up with another reason? I can think of 10. But I'm invested. I think everyone should be able to think of ten. Because I guarantee you that your perception of a what a mentally ill person can or cannot accomplish will change. And in a case that figures such people as Isenschmidt, Levy, Cohen, Kosminski, Druitt, it matters a great deal what they could or could not have accomplished.

Win/win I think. Understand the case, understand your fellow man.

[Scott Nelson]

4. We can't even be sure of the nature of the crimes. Each one was different.

[lynn cates]

the crimes

Hello Scott.

"We can't even be sure of the nature of the crimes. Each one was different."

No argument here.

Cheers.
LC

[Colin Roberts]

No sufferer of OCD would be able to tolerate any interruption of their ritual, and very likely would not leave, even under threat of discovery. Nothing else would matter but finishing what he meant to do.

Fallacy!

[Errata]

Fallacy!

How so? OCD rituals are solely for the purpose of relieving intense distress and anxiety. They can't stop. Try to stop them and they fight. Now there are any number of therapies available today, including medication, CBT, DBT, etc. that can make a world of difference, but those were not available back then. Not only that, but no one knew what OCD behaviors were trying to accomplish. So even if someone dragged a guy kicking and screaming away from the crime scene, he would be compelled to try and finish in some fashion.

Of course, OCPD is a different beast. It's much more akin to Generalized Anxiety Disorder, which can be pushed through if need arises. But OCD is as intense as psychosis. And as demonstrated by the remarkable amount of compulsive behaviors that are destructive, personally harmful, and even potentially fatal, self preservation is not a factor in this disease. Frankly it's hell.

This is of course with the caveat that the OCD is compelling this person to kill, not that they are a serial killer who, oh by the way, washes his hands 137 times a day.

[Colin Roberts]

OCD rituals are solely for the purpose of relieving intense distress and anxiety. They can't stop. Try to stop them and they fight.

Let me guess: Psychology 101.

OCD is as intense as psychosis. And as demonstrated by the remarkable amount of compulsive behaviors that are destructive, personally harmful, and even potentially fatal, self preservation is not a factor in this disease. Frankly it's hell.

Intense?

Hell?

I seriously doubt that you will ever have the slightest semblance of an appreciation for the intensity of the agonizing hell, in which I have had to spend much of my life, because of my Obsessive Compulsive Disorder!

This is of course with the caveat that the OCD is compelling this person to kill, not that they are a serial killer who, oh by the way, washes his hands 137 times a day.

OCD in itself would not compel someone to kill! Period!

[Errata]

Let me guess: Psychology 101.



Intense?

Hell?

I seriously doubt that you will ever have the slightest semblance of an appreciation for the intensity of the agonizing hell, in which I have had to spend much of my life, because of my Obsessive Compulsive Disorder!



OCD in itself would not compel someone to kill! Period!

Actually I think I'd be able to make a pretty good guess, since I have it too. One of the really good scarring, disfiguring kinds too if it makes you feel better. OCD can compel people to kill. And it has. It is extraordinarily rare, but it has happened. And it all hangs on the delusional component.

As I imagine you well know, the compulsion has a delusion backing it up. Usually something non specific, like "something bad will happen if I don't do this thing." Sometimes it's a little more specific, like "it hurts if I don't do it" "someone will die" "I will die", etc. Sometimes it's coupled with a phobia. In such cases the fears are very specific, but the remedies are also very specific. That's where the line blurs. Because OCD has such a huge degree of magical thinking involved, any action that relieves anxiety can become a compulsion. Be it counting, washing, picking, even killing. Richard Chase was Schizophrenic, but he also had OCD coupled with his schizophrenic delusions. It's what shaped the method and reason for his killing. Blood relieved his anxiety over the delusion of illness. Much like hand washing does for others. Extremely rare. But possible.

Look I have a score of diagnoses. OCD is only one of them, but quite frankly the one that has shaped me the most. Because quite frankly if you don't think an adolescent girl with an awkward and disfiguring disease doesn't develop a whole lot of issues, think again. And I'm not a killer. And no one else I know with OCD is a killer. But my CBT therapist had one as a client. She'd drive out to the prison to treat him. Do I think Jack the Ripper had OCD? No. I really don't. But I'll entertain the possibility.

Frankly, you know damn well that mental illness doesn't make us something we aren't. There is no disease on the planet that could make killers out of either of us. You have OCD. I know that sucks. But I don't feel sorry for you, because you aren't dying, and you aren't going to go all Flowers for Algernon on us. We lose a lot. But never our own nature. And if you got offended because you thought I was some tourist spouting nonsense, then let me assure you. I am no tourist, and this is not nonsense. A monster with OCD is still a monster. But anyone who thinks people with OCD are incapable of violence are dead wrong. Rage is a HUGE component in a frustrated compulsion, and people lash out. I've done it. I've hit people who tried to grab my hands and force them down. I've screamed, I've shouted, I head butted my sister once when she trapped my hands and wouldn't let me go. People do not come between an OCD sufferer and their compulsion unscathed. As any number of school bullies have learned. Yes, most of the time we lash out verbally. But not always. And can you imagine what would happen if you swung at someone and found that the sensation of knocking someone to the floor was better than whatever your compulsion is? I can't tell you how many things I don't do, won't even try because I'm afraid of substituting behaviors.

Though since I've been doing one of mine while typing this and the left side of my face is bleeding, sometimes it's hard to imagine what can be worse than this.

I'm just trying to have an honest discussion about all of this. A lot of psych stuff gets flung around, and I do it too. I can't let people think that the mentally ill are dangerous, when the vast majority of us are not. But I don't think it's useful to pretend that we can't be dangerous. For whatever reason. I'm as dangerous as the guy who stood behind you the last time you were in the elevator. But that guy could have killed you. So if someone is going to live in fear of us, they better be damn well willing to live in fear of everybody. That's my take. Disagree if you like.

[Mr Stu]

Well eloquently is perhaps the word I was looking for but you managed to articulate something I’ve been trying to for a while but I’m far better at talking in person than translating my thoughts in a legible form by typing them out – it ends up gobbledeegook like this most likely will…
Plus something you wrote chimed very much with me personally, something again I’ve struggled to pin down./express.
I’m of the opinion that the suspect list is peopled by poor souls who were just unfortunate enough to be suffering from or whose behaviour was perceived, at the time, to be a mental disorder and that they were therefore judged more likely to be the killer than somebody who was for want of a better word regarded as “normal”. Which is of course nonsense. I can’t see any other reason or evidence that made them suspects except prejudice and false assumption really.
Poorly put by me – I told you I can’t do this very well – but I think too much stock can be put (even today when we should be more enlightened) in this guy, or this guy being more valid as a suspect/more likely to kill because they suffered mental health problems and it’s wrong.

[Errata]

Well eloquently is perhaps the word I was looking for but you managed to articulate something I’ve been trying to for a while but I’m far better at talking in person than translating my thoughts in a legible form by typing them out – it ends up gobbledeegook like this most likely will…
Plus something you wrote chimed very much with me personally, something again I’ve struggled to pin down./express.
I’m of the opinion that the suspect list is peopled by poor souls who were just unfortunate enough to be suffering from or whose behaviour was perceived, at the time, to be a mental disorder and that they were therefore judged more likely to be the killer than somebody who was for want of a better word regarded as “normal”. Which is of course nonsense. I can’t see any other reason or evidence that made them suspects except prejudice and false assumption really.
Poorly put by me – I told you I can’t do this very well – but I think too much stock can be put (even today when we should be more enlightened) in this guy, or this guy being more valid as a suspect/more likely to kill because they suffered mental health problems and it’s wrong.

I don't blame anyone for their fear. It isn't right, and it isn't okay, but it is perfectly reasonable. The first thing people think of when they think of mental illness is that these people are out of control. And that's true. We do not have control of certain functions that other people do have control over. Now it's no different than epilepsy, or diabetes, or MS, which are not scary. I can't control my serotonin and dopamine any more than a diabetic can control his insulin production. So why am I scary and a diabetic is not? Well, that's pretty simple. If a diabetic's system goes horribly awry, he can die. If my system goes horribly awry, I lose control of my judgement and my behavior. Now, only within certain parameters, but I do lose control. And it scares people to see me altered in that fashion. It never occurred to my friends that I was remotely a reckless person, until they saw me in a Bipolar episode for the ages. It was so out of character that they wondered what else I was capable of in that state. And I don't blame them. I know what I'm capable of, but it never occurred to me to tell them. Now, I've been training them for so long at this point that nothing phases them. They even help me when things get bad. And I am very lucky.

But what do most people know about mental illness? They know it's not our fault. Which is good. They know it's a malfunction in the brain. It affects 2% of the population. So who do most people know who have a mental illness? Ranting homeless guy, coworker's sister who committed suicide, and what they see on TV, movies, and in the news. There's a show, Homeland, in which the main character is Bipolar. It is the most realistic depiction of the disease I have ever seen, and it is still waaaaay off. Who else do we have with a mental illness in our consciousness? Jared Laughner? James Holmes? Buffalo Bill? Syd Barrett? Not really shining examples of the success of the mental health system.

You know who else have mental illnesses? Catherine Zeta-Jones, Ashley Judd, Emma Thompson, Michael Phelps, Buzz Aldrin, Rosemary Clooney, Ben Stiller, Daryl Hannah, Adam Levine, Lionel Aldridge, Stephen Fry, Ted Turner, David Beckham... a whole lot more. These are successful people, who have ADHD, Bipolar Disorder, OCD, even Autism. And these people are "out", they talk about it. Somehow those examples don't stick. When people think "mental illness" they don't think Buzz Aldrin. They think ranting homeless guy. Maybe people think that these celebrities are somehow the exception. But they aren't.

In the LVP, there was really no chance at all for someone with a mental illness, and that affects perception. There were no treatments, there were no cures. They were just out of thinking that mental illness was demonic possession, but not yet at the point of recognizing a structural problem in the brain. They thought mental illness was the fault of the sufferer. They did SOMETHING that caused it. Though no one was sure what that something was. But today we have all kinds of treatments and therapies and medications to keep us on an even keel. They didn't have that. They had an endless progression. They had nothing to stop what was happening. A few people probably cobbled together some tips and tricks to deal with certain symptoms. And avoidance was probably a popular one. But they tended to get a lot sicker a lot faster than we do now. And it's entirely possible that someone with my symptoms back then would descend to a level I will never reach. I get why they thought the Ripper was insane. I disagree, but I have access to knowledge they didn't have. And it's not impossible. But we live in 2012, and we do not have any excuse to think the way that they thought. Mental illness does not a suspect make. At most, mental illness is one of the criteria of trying to identify Anderson's suspect. Understand the illness, understand the symptoms, and then come to a conclusion. But every disease, every behavior is more than it's definition in the DSM-IV. And the sooner people understand that, the better.

[katemills]

I agree with what you have written Errata. I'm not a Ripperologist who is trying to unmask JtR so I don't feel the need to single any suspects out and diagnose them; I'm more intrigued by the evaluations of why each suspect is a suspect, how people have come to regard them as such, the 'suspect's' way of life, recorded personality traits/communications etc. This applies to every suspect named, aswell as the general populace and their living conditions and ways of life at that time. Granted there are those who are more interesting than others.

I have OCD and have suffered other mental health issues in the past, pretty much from my mid-primary years. All have been caused by emotional stress from varying sources. It's painful, I have memory issues through it (non-recent) but it hasn't made me a bad person or a killer or insane. It's just part of my make-up. I function well alongside the OCD which is the predominant issue nowadays. I wish it wasn't there; it's embarrassing, invasive and controlling. It fluctuates in intensity depending on my state of mind - general stress and worry is the influencing factor aswell as one singular event in my past that causes me high emotional stress which 'flares up' the OCD if I think about it at all. However, even when I don't feel stressed or worried, it is still there.

I don't see how OCD could initiate a killer instinct either, there would have to be far more serious psychological conditions for it to play any sort of part in the role of murderer, in my opinion.

[Errata]

I don't see how OCD could initiate a killer instinct either, there would have to be far more serious psychological conditions for it to play any sort of part in the role of murderer, in my opinion.

Like I said, I have heard of guy who replaced self injurious behavior with violence and murder. But I don't know how it happened. And I don't know that OCD needs to create a killer instinct, as long as it informs the method of killing. If say, he killed because he was just one of those guys, but his OCD dictated the form of the mutilations, if he had a personal ritual, that's a big problem for someone who kills out in the open, and can be interrupted. I don't know that he would be able to leave before finishing whatever it is he did. Someone with OCD isn't a killer. But a killer with OCD is going to have compulsions regarding the killing. Which makes him vulnerable.

[Edward]

Random thoughts ...

Hello All -

But every disease, every behavior is more than it's definition in the DSM-IV. And the sooner people understand that, the better.

I absolutely agree that mental illness in any form should not in and of itself make a person a suspect in these crimes. Society in 1888 didn’t have the understanding of mental illness that we now have. Having said that, I feel that a person with a mental illness and a history of violence (especially against women) is worth considering as a suspect (if time and place indicate opportunity), as well as people with a history of violence not considered to be mentally ill.

DSM-IV cannot be applied in this case, simply because the observations that are used to arrive at a diagnosis must be made in a clinical setting. Testimonials and hearsay are not clinical observations. DSM-IV pigeonholes a patient into a diagnosis based upon observed behavior. It shoehorns patients into a diagnosis based upon those clinical observations. One of the criticisms of DSM-IV is that patients may not behave in their usual manner when placed in a clinical setting. It is my belief that in many cases, mental illness is a spectrum of behaviors or compulsions and not a “pure” case of one diagnosis only. DSM-IV handles that issue by assigning two (or more) diagnoses, which I, too, do not feel is an accurate picture of patients in those conditions, Errata.

In the case of the Whitechapel Murders, the killer apparently had the ability to perform at least rudimentary pre-planning (brought a knife along) and the ability to perform whatever it took to evade detection and escape the crime scene. Diagnoses that rule out those types of behaviors should probably not apply. However, must a serial killer have a mental disorder? Possibly, but then, maybe not.

Edward

[RivkahChaya]

Thank you for saying this. It drives me batsh!t when people read wikipedia or salon.com articles on Asperger's syndrome, then go around claiming that people like Einstein or Stonewall Jackson had it. Aside from the fact that one necessary criterion for diagnosis is that it "interferes with normal daily function," you just can't do that. Any actual psychiatrist, neurologist, or Ph.D psychologist, which is to say, people who are qualified to make that diagnosis, won't diagnose someone they have not met. Most especially historical figures. At the very most, a colleague might look over someone else's notes after a diagnostic meeting, and say yes, or no, they would concur, given those observations.

That said, I think you can sometimes make a binary call over whether someone probably did, or probably did not, have mental health issues, but that is about all, and then, you would need to be very sure of your information. People have tried to pin down what exactly was wrong with King George III, and in that case, we do have lots of recorded observations by some people who were attempting to be objective. I don't think we can ever know exactly what was wrong, but I think it's safe to say "Something was wrong." He wasn't just over-stressed; there was actually a pathological process somewhere in his brain, or his endocrine system, or somewhere.

I think we can probably safely say that Aaron Kosminsky, the man who was committed to an institution, had some kind of mental illness. I think it's fair to say that the reported symptoms sound a lot like what we now call schizophrenia. But I don't think we can ever know enough for a definitive diagnosis. It's possible he had a degenerative brain disorder, either genetic, or from an infection; the odds favor schizophrenia-- if the reports of his symptoms are reliable.

The thing about King George and Kosminski is that they were not functioning well day-to-day, and pretty much everyone around them agreed that something was wrong. We're not taking someone who was perfectly fine, like Stonewall Jackson, and saying "Look how smart I am, I can figure out that this guy had something wrong with him when no one who actually knew him noticed."

Now, assessing Jack the Ripper is completely different. We don't know if he is even a real person. He could be one murderer, or five. We don't know his motivation. We don't know his age. We don't know where he grew up, whether he was capable of holding any sort of job, or possibly of appearing relatively successful. "Committing murder" is a horrible thing, but it doesn't qualify as failing to function, especially if one is not getting caught. That's actually pretty high-level functioning, in a sort of ironic way. We don't know so many things: we don't know whether he ever wrote a letter to anyone, and if he did, we don't know whether he made any spelling or grammar errors because that's the limit of his education, or because he was deliberately trying to disguise his writing.

I don't think we can make even a binary assessment of JTR, because we would be assessing a phantasm.

About the only thing we can say is that, statistically speaking, he is unlikely to be schizophrenic, or have one of the psychotic-type PDs, but is likely to have some issues either with substance abuse or depression. And that is based on stats gathered in the 20th century. They may not hold true for Victorians.

But just to add one thing: schizophrenics are not more likely than other people to commit violent crimes. They are not less likely either, except to the extent that they are often supervised much of the time. However, if you look at the statistic the other way, since a certain percentage of the general population is schizophrenic, a certain percentage of violent offenders are also schizophrenic. However, the crime is marked in type: schizophrenics don't usually premeditate violent crimes, and get away with them afterward, because they skillfully cover their tracks. In fact, because a lot of schizophrenics think other people can monitor their thought, they assume they can't get away with crimes. If a schizophrenic did commit a ripper-like murder, he'd likely be caught just standing there with the knife once he was done, and admit it to the first person who walked by-- and yes, I have known several schizophrenic people, because I was a social worker who did supervised community living situations for people with disabilities.

Thanks for posting this, Errata.