The environment as a factor in the aetiology of criminal paranoia.

DURING several years of service at Broadmoor and in the prisons the writer saw a number of cases of criminal paranoia, and was impressed by the importance of external situations in the aetiology of the psychosis. The purpose of this short paper is to draw attention to the environmental stresses to which some of these patients have been subjected, arid to try to show that criminal paranoia may sometimes be a reaction to an intolerable and inescapable predicament. Paranoia is often said to be one of the most dangerous forms of insanity, but it is not a very common cause of serious criminality. Cases of true paranoia, as described by Kraepelin, are rarely seen in prisons, and they are as rare in Broadmoor as in other mental hospitals. Paranoidal cases in general are not very common, and of 300 consecutive male homicides admitted to Broadmoor only 45 were suffering from a systematized delusional psychosis. The late Dr. \V. C. Sullivan, a former Medical Superintendent of Broadmoor, in his book on Crime and Insanity suggested that the evil reputation of paranoiacs was based on their attitudes while under restraint rather than on their criminal achievements, and in a series of 66 cases of paranoidal crime studied by East,