discussion of Aaron Kosminski's psychological profile

[Abby Normal]

Well, like Rob said, there are major gaps in the records that relate to Kosminski. But from what is known about him, he was presenting symptoms of different stages of an affective personality disorder, like depression and mania. This is one of the reasons I believe he was Bipolar, though a lot of these symptoms indicate it *could* have been Schizophrenia.

There were times when he was clean, then other times when he could not or would not take care of himself and refused to be bathed.

at times, he was incoherent and would barely mutter answers to questions. then other times where he was noisy and troublesome. then, a few months later, quiet.

he, at least in the beginning, experienced psychotic episodes like hallucinations and delusions ("he says he knows the movements of all mankind", he is "told" to refuse food from others, and is "guided" by an "instinct")

at times he was violent, at other times, not at all.

towards the end of his life, it seems like what "normalcy" he had was completely gone and his mind and body were pretty much shut down.

basically, from the few notes we have, his behavior would have been very unpredictable depending on whether he was experiencing mania or depression.

What about at the times of the murders-fall 1888?

[Chris]

Very little is known about his physical appearance. I believe I've seen it said that he had dark hair, average height (possibly, but I'm not sure), and very slight build (at least at the time he died, he's was very slight).

Unfortunately not even that much is known, I think.

The only thing we really have is a record of his weight in the final years of his life:

http://forum.casebook.org/showpost.php?p=98048&postcount=64

Obviously he was ill at the time, so it doesn't tell us very much about his build, though my guess is that he wasn't more than a few inches over five feet tall.

http://forum.casebook.org/showpost.php?p=98172&postcount=70

[Chris]

However,once again I went through every comment made by Kosminski"s doctors and not one of them mention it in connection with his illness! So this seems to have come mainly from the family.

Actually, "self-abuse" is mentioned twice as the cause or supposed cause of Aaron Kozminski's illness - once in the Colney Hatch Register of Admissions (LMA H12/CH/B2/2) and once in the Colney Hatch Case Book Male Side (LMA H12/CH/B13/39).

Of course, it is also mentioned in Dr Houchin's summary of the information provided by Jacob Cohen, but only as the bare statement "He is melancholic, practises self-abuse."

[corey123]

Hello Nats,

I have to disagree with your notion that only those with a degree in psychology, yes psychology, not only psychiatry, can make an accurate diagnosis. The problem with Pontius is he is using his own opinions and not legal diagnostic critera, like DSM-IV-TR or the ICD, or any of the like. These manuals contain specific diagnostic criteria that must be present for the proper conclusion of a disorder.

No doubt, I am young, but I know quite a bit about psychology, and do a bit of diagnosing(not legal diagnostics, but, shall we call them conclusive ideals) of certain persons. Recently, I have be writting up an analysis of the Colney Hatch records pertaining to Jacob Isenschmid. Now, this is not crazy, for it will be accurate.

Anyhow, I concure with Rob. From what little I have read I do believe he either had Schizophrenia or Schizo-affective mood disorder. Pontius, you do know that there being psychotic symtpoms makes it impossible for a pure manic depressive rulling in this case right?

Thanks

[corey123]

Hello All,

Just for the record, since the subjects of anti-psychotics were brought up.

Modern day antipsychotics for schizophrenics, bi-polar patients, and many related disorders in the first Axis of the DSM-IV pin-point a brain chemical responsible, in different ways, for these disorders, called Dopamine, and it is a neurotransmitter. In Schizophrenia, the excess activation of a D2High in the mesolimbic pathway in the PFC(prefrountal cortex) causes the positive symtpoms and the excess activation of a D1Low(D1-D2 are receptors for dopamine in the dendritotic end of a chemical neuron)in the neocortex are responsible for the negative symptoms. In these disorders, they block these receptors, while not curing the disease, it discontinues symptoms during a psychotic episode. This technich is new and the only procedure that really worked in these cases would be restraint.

Whew, thats alot, well not really.

For those whom it may concern, hope you find it interesting.

Yours truly

[Natalie Severn]

Actually, "self-abuse" is mentioned twice as the cause or supposed cause of Aaron Kozminski's illness - once in the Colney Hatch Register of Admissions (LMA H12/CH/B2/2) and once in the Colney Hatch Case Book Male Side (LMA H12/CH/B13/39).

But it forms no part of the doctors observations beginning with, "He declares he is being guided and his movements altogether controlled by an instinct ...."
.........."As mentioned in the certificate he believes that all his actions are dominated by an "instinct" .This is probably aural hallucination".....etc

On February 10 1891 the first observation is recorded at Colney Hatch viz:

"Is rather difficult to deal with on account of the Dominant Character of his delusions [their capitals].Refused to be bathed the other day as his "instincts" forbade him."

So it appears that the initial diagnosis from the doctor by emphasising his delusions pointed the way to the effect such delusions could be expected to have on his behaviour.

Nothing about sexual preoccupations or obsessions.

[jason_c]

What about at the times of the murders-fall 1888?

He seems to have looked and acted fairly normally in 1889.

[corey123]

Hello Jason,

If it was a Schizo-typal disorder, then with the periods of unstability, they would be long periods of coherence and stability. The disorder is usually at bay to the environment, such it is much like a cold, if predisposed, the environment affects the affected health very substantially.

[Natalie Severn]

Hello Nats,

I have to disagree with your notion that only those with a degree in psychology, yes psychology, not only psychiatry, can make an accurate diagnosis. The problem with Pontius is he is using his own opinions and not legal diagnostic critera, like DSM-IV-TR or the ICD, or any of the like. These manuals contain specific diagnostic criteria that must be present for the proper conclusion of a disorder.

No doubt, I am young, but I know quite a bit about psychology, and do a bit of diagnosing(not legal diagnostics, but, shall we call them conclusive ideals) of certain persons. Recently, I have be writting up an analysis of the Colney Hatch records pertaining to Jacob Isenschmid. Now, this is not crazy, for it will be accurate.

Anyhow, I concure with Rob. From what little I have read I do believe he either had Schizophrenia or Schizo-affective mood disorder. Pontius, you do know that there being psychotic symtpoms makes it impossible for a pure manic depressive rulling in this case right?

Thanks

What I meant to be understood Corey, was that for an accurate diagnosis of mental illness only a psychiatrist in consultation with the patient in person could make such a diagnosis--and even then a "one off" consultation might be insufficient.
I have worked with patients who manifested such symptoms as Aaron Kosminski .This was in a large psychiatric hospital in the North West of England.I was engaged in a special study of such illnesses .
I too suspect he was suffering what might,for simplicity sake be termed schizophrenia of the paranoid type.

I agree with you too that environmental factors can impact significantly --but not solely, on the onset of a psychosis.

[corey123]

Hello Nats,

I agree. Still, making an assumption without consulting either the DSM-IV or the ICD or a profession is utterly foolish.

Yes, I woulb believe it be a combination of heredity, environment, neurocognitive circumstances, and outer and intra stimuli.

It may very well be the paranoid type. It isn't catatonic, not residual, not undifferentiated. Don't forget of disorganized.

Anyhow, the only way to truly make a close assumption of ones mental condition would be from a first hand source.

[Marlowe]

Ergot ( yawn :-)

Marlowe

[Pontius2000]

Ergot ( yawn :-)

Marlowe

do you want to elaborate? do you believe Kosminski suffered from ergot poisoning or are you just throwing out random words?

[corey123]

Hello Pontius,

You read my mind. I took the liberty of reading some of his posts, which I found to be quite nasty, so I chose not to comment.

I, however, am very interested.

[Marlowe]

Hello Pontius,

*Complusive masturbation=low prolactin, high dopamine (dopamine agonist)
*LSD-like hallucinations (knowing the destiny of ALL mankind)
*Gangrene of the leg=vasoconstriction
*Weight loss
*Excessive thirst
*Depression

There are other reasons, as well. For example:

Did he go about the street picking up bread?

[corey123]

Hello Marlowe,

I see we agree that dopamine(agonist) had a play in this?

Odd that you would assert that it may be related to hypersexuality. I could see that as in hyposexuality, dopaminergic depletion could be found, as in depression. However, this is unlikely. However, the LSD like hallucinations are not hallucinations, but delusions, caused again by excess activate of D2 receptors in the mesocortal area of the PFC. Yes, certain drugs, mainly amphetamines, in turn replace the neurotransmitter dopamine and release excess amounts of the chemical, causing a temporary 'high' remenescent of the posative symptoms of many disorders. Depression is a common negative symptoms of Schizophrenia,(e.i. flattening effect) caused by the excess activation of the D1 receptors. Weight loss and excessive thrist are irrelevant, but possibly telling, though most likely not.

I agree, it is possible, but only such.