Following the argument of the mother who murdered her son: how do you diagnose a psychotic attack?

The “psychosis” claim of the murdering mother: Sigal Itzkovitz, who is accused of murdering her six-year-old son, experienced a psychotic attack, the prosecutor’s office stated yesterday (Monday) at the Tel Aviv District Court. The opinion also stated that she is competent to stand trial.

After she claimed that aliens ordered her to murder Liam: this is what was revealed on Facebook by the suspected mother

As I recall, the horrific tragedy occurred about two and a half months ago: while staying at her home with her son and dog, Itzkovitz took a knife from the kitchen, first stabbed their dog and then approached her son who was in the bathtub and stabbed him dozens of times in all parts of his body. As a result of the force of the stabbings, the knife broke, in such a way that the tip of the blade remained embedded in the skull.

Itzkovitz came out of the bathroom after the murder, heard the howls of the wounded dog and, fearing that neighbors and passers-by would hear the howls, closed a shutter and stabbed the dog dozens more times with a knife and an ax, until she died.

After that, the accused washed the knife with which she killed her son, changed her clothes and left the house towards the “Seven Stars” mall, covered in blood and holding an ax in her hand. On the way, the accused attacked with the ax a passerby who was cut in her path and also stuck the ax in the hood of the car on the road. When she arrived at the mall, she attacked the security guard, who struggled with her in an attempt to take the ax from her.

In the previous hearing, Itzkovitz claimed that her family was abducted by aliens: “My son underwent experiments in a spaceship, it was horrific and horrifying. They invaded our home and body and acted through us. My son’s blood was not spilled for nothing. There are aliens among us and they roam among us on Earth.”

From hallucinations to haunted feelings
A psychotic attack is a situation in which the person loses contact with reality temporarily, and experiences severe symptoms that affect his perception of the world. Common symptoms include hallucinations, in which the person hears or sees things that do not exist in reality, and delusions – false beliefs such as feelings of persecution or belief in supernatural powers.

People in a psychotic attack may show disorganized thinking and behavior. They have difficulty communicating logically and sometimes engage in unexpected behaviors, which may also include violence. A psychotic attack may appear as part of mental illnesses such as schizophrenia or bipolar disorder, but also in other medical conditions or following drug use.

In extreme cases such as murder, several factors can contribute to the outbreak of a severe psychotic attack, to the extent that the person loses control of his actions. These include serious mental illnesses such as schizophrenia, depression or bipolar disorder, drug use such as cannabis, amphetamines or alcohol, severe mental trauma, and also medication or discontinuation of medication.

To diagnose a psychotic attack there are several clear criteria:
Duration of symptoms: The psychotic symptoms must last for at least one day but no more than a month for the condition to be considered a psychotic episode and not a chronic illness.
Presence of hallucinations or delusions: These are necessary symptoms to diagnose a psychotic attack.
functional disorder: A person suffering from a psychotic attack will find it difficult to lead his life normally.
Exclusion of other factors: Other medical conditions or drug effects should be ruled out.

However not every extreme atrocious act is defined as psychosis. For example, if there is evidence of a careful planning of the murder, this can negate the claim of a psychotic attack since a person in such a situation often acts impulsively rather than planning. In cases where there are other motives such as a personal or financial conflict, it is possible that the act was done out of full awareness and not following a psychotic attack. Meanwhile, a person who was in a real psychotic attack will have difficulty understanding the meaning of his actions immediately after them.

Hospitalization, medication and prolonged rehabilitation
The treatment of a psychotic attack combines pharmacological, psychiatric and psychotherapeutic approaches, with an emphasis on immediate treatment of the acute symptoms and prevention of repeated attacks. Antipsychotic drugs such as risperidone or olanzapine are usually given to reduce hallucinations, delusions and disorganized thinking. In cases of extreme restlessness, sedatives such as benzodiazepines may be combined.

In risky situations, psychiatric hospitalization may be necessary for observation and intensive treatment. After the acute condition is stabilized, psychotherapy helps the patient cope with the attack and develop tools for future coping. The psychotherapeutic treatment may include cognitive-behavioral or psychodynamic approaches, which help to understand the internal conflicts that led to the attack.

Family and social support is an essential part of recovery, as stable support systems reduce the risk of repeated attacks and facilitate the patient’s return to routine. At the same time, it is important to continue drug treatment and perform regular psychiatric follow-up to prevent recurrence of seizures. In some cases, the addition of antidepressants or mood stabilizers may also be needed, especially when the attack is associated with bipolar disorder or major depression. Social and occupational rehabilitation is an important part of the treatment and helps the patient return to normal functioning through professional guidance and assistance in developing life skills.

As horrifying as this may sound, according to Israeli law, a person who commits a murder under a psychotic attack will not always be in prison, and may be declared “not responsible for his actions” – lack of criminal responsibility. In such a case, the court can order an involuntary psychiatric hospitalization for an unlimited period, in order to protect the public and allow continuous treatment for the accused. However, if it turns out that the person was partially aware of his actions or that the psychotic function was not significant enough to be exempt from full criminal responsibility, he may be sentenced to prison with concurrent psychiatric treatment.