Artigo de revisão
CRIMINALLY BIPOLAR: A SYSTEMATIC REVIEW ABOUT BIPOLAR MANIA AND CRIMINAL BEHAVIOR
Como citar: Dias NDM, Nascimento AN, Almeida GSD, Arthur RGDP, Ribeiro SS, França AMS. Criminalmente bipolar: uma revisão sistemática sobre a mania bipolar e o comportamento criminal. Persp Med Legal Pericia Med. Vol. 10, 2025; 250843.
https://dx.doi.org/10.47005/250843Aceito em 04/09/2025
The authors report no conflict of interest.
CRIMINALLY BIPOLAR: A SYSTEMATIC REVIEW ABOUT BIPOLAR MANIA AND CRIMINAL BEHAVIOR
Resumo
INTRODUÇÃO: O Transtorno Afetivo Bipolar (TAB) tipo I é compreendido como um transtorno episódico, consistindo em episódios de depressão e mania, podendo haver psicose. OBJETIVO: Identificar, na literatura científica, a existência da possível correlação entre os episódios de mania bipolar e o comportamento violento e/ou criminal. MÉTODOS: Conduziu-se uma revisão sistemática entre em junho–julho/2024 nas bases: PubMed e BVS, em inglês, mediante busca com termos MESH. Elegeram-se artigos relacionados, originais, publicados nos últimos 10 anos. Excluíram-se os demais estudos. Duplicadas foram consideras uma única vez. RESULTADOS: Encontraram-se 974 artigos nas bases selecionadas, sendo 464 duplicatas. Elegeram-se 12 embasado no título e resumo. Recuperaram-se 18 obras de fontes adicionais. Trinta artigos foram analisados na íntegra e 15 foram incluídos nesta revisão. Os principais fatores correlacionados à violência/agressividade no TAB I foram: sistema imune e estado pró-inflamatório, polimorfismo genético, sexo genético masculino, consumo de substâncias, história de violência, traumas na infância e estados maníacos/psicóticos. DISCUSSÃO: A diversidade cultural e a variedade de subtemas nos artigos refletem a distribuição global e a etiopatogenia multifatorial do TAB. Estudos sugerem envolvimento de fatores como: história de violência, níveis elevados de marcadores inflamatórios e polimorfismos do gene GRIK2, no comportamento agressivo na mania bipolar. Sugere-se que o uso de substâncias e traumas de infância elevam o risco de violência. CONCLUSÕES: A mania correlaciona-se à maior propensão a comportamentos violentos/criminais. Fatores de risco incluem: falta de tratamento psiquiátrico, traumas na infância, uso de substâncias e histórico de violência.
Palavras Chave: psiquiatria legal, transtorno bipolar, comportamento criminoso
Abstract
INTRODUCTION: Bipolar Affective Disorder (BD) I is understood as an episodic disorder, consisting of episodes of depression and mania, with the possibility of psychosis. OBJECTIVE: To investigate and identify, in the scientific literature, the existence of a possible correlation between episodes of bipolar mania and violent and/or criminal behavior. METHODS: A systematic review was conducted between June and July 2024 in the PubMed and BVS databases, in English, using the MESH vocabulary. Original related articles published in the last 10 years were chosen. Other studies were excluded. Duplicates were considered only once. RESULTS: Originally, 974 articles were found in the selected databases, 464 of which were duplicates. Twelve were selected on the basis of title and abstract. Eighteen articles were retrieved from Consensus, 30 articles were analyzed in full and 15 were included in this review. The main factors correlated with violence/aggression in BD-I were: immune system and pro-inflammatory state, genetic polymorphism, male genetic sex, substance use, manic and psychotic states, history of violence and childhood trauma. DISCUSSION: The cultural diversity and variety of sub-themes in the articles reflect the global distribution and multifactorial etiopathogenesis of BD. Studies suggest the involvement of factors such as: history of violence, high levels of inflammatory markers and polymorphisms of GRIK2 in aggressive behavior in bipolar mania. It is suggested that substance use and childhood trauma increase the risk of violence. CONCLUSIONS: Mania correlates with a higher propensity for violent/criminal behavior. Risk factors include: absence of psychiatric treatment, childhood trauma, substance use and history of violence.
Keywords (MeSH): forensic psychiatry, bipolar disorder, criminal behavior
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