via Forensic and General Psychiatry Review by Mike Nova on 4/28/12
Response to Dr. Kringlen
Dr. Kringlen: “My professional experience suggests he is unlikely to have been able to act in such an adequate fashion if he is psychotic, in particular schizophrenic,” he declared, saying it is extremely unlikely Breivik has managed to mislead him in his battle to appear as sane.
‘Two days in court changed my opinion of Breivik’, says top psychiatrist / News / The Foreigner — Norwegian News in English.
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Response: by Michael Novakhov, M.D.
"According to German psychiatrist, Emil Kraepelin, patients with Delusional Disorder, remain coherent, sensible and reasonable[4]. "
...
"The delusions do not interfere with general logical reasoning (although within the delusional system the logic is perverted) and there is usually no general disturbance of behavior. If disturbed behavior does occur, it is directly related to the delusional beliefs."
References and Links
Delusional disorder - Wikipedia
via Forensic and General Psychiatry Review by Mike Nova on 4/27/12
Response to Dr. Wessely
Normality or psychopathology of belief or belief system is determined first of all by the intrinsic qualities of belief in question. It is not determined by the fact that belief is shared or not shared: "Delusions are beliefs that are not only wrong, in the sense of not corresponding to the world as we know it, but they must also not be shared with others of the same cultural background."There are many delusional beliefs that are or were shared, and some of them on a rather large scale. For example, the ancient Maya believed, that for the sun to rise they had to offer human sacrifices (of their best and brightest) every day, otherwise all kind of life on earth would come to a halt. This belief was shared very widely in ancient Maya culture, which does not make it less delusional.
Breivik's ultra nationalist anti-immigrant ideology is shared by great many people of various cultural backgrounds. The goal of his forensic psychiatric evaluation is to assess his own particular belief system, with all its peculiarities and idiosyncrasies, in order to determine its nature, qualities and psychopathological aspects, regardless of other similar beliefs. In the end, it was him, not others, who took these ideas to their logical (or rather illogical and "sick") extreme, although the (possibly facilitating) role of "significant others" in his case still has to be determined.
Neither the "monstrosity" and "grievous consequences" of his actions nor "popular misconceptions" should cloud the picture. The most important factor in his forensic psychiatric assessment is the presence or absence of identifiable and diagnosable mental illness and the degree of its causal relationship with the crime. In my opinion, whatever it is worth, psychopathological qualities of Breivic's beliefs: their highly systematised, structured, all embracing "world view" quality, along with their unshakable, messianic conviction and "call for action", indicate with high degree of probability the presence of Delusional Disorder, mixed, persecutory-paranoid type, and the direct and overwhelming causal connection of his psychopathology with the criminal act.
The cognitive aspect in psychopathology of Delusional Disorders (abnormalities and/or dysfunctions in concept selection, elimination and confirmation), indicating possible subtle but decisive organic involvement is much under-researched area, probably due to our neglect or inattention to biological aspects of these disorders and overestimation of its psychodynamic aspects. Delusional jealousy, secondary to chronic alcoholism (a very discrete and specific syndrome) is the case in point.
"The... misconception... that the purpose of psychiatry is to “get people off”" might be as wide spread as any other misconception, which does not make it any less of a misconception. The historically formed legal concept of "NGRI: not guilty by reason of insanity" is a witness of humanity and rationality on the part of society, not to mention other, less important but present factors, such as political and social convenience, expediency and cultural traditions. (E.g.: Disraeli to Queen Victoria: "Only the madman can think about assassinating your Majesty..."). Modern psychiatry, very likely, was born out of the M'Naghten rules, as some psychiatric historians suppose.
And last, but certainly not least, is the difficult and complex subject of "Schizophrenia", its clinical concept (and/or misconcept) and diagnosis (and/or misdiagnosis). The diagnostic label of "Schizophrenia" became so wide spread and all encompassing (because it is so easy to apply, and is applied almost indiscriminately), as to loose its meaning and clinical value. In our rush to nosological (and reimbursement) parity with the rest of medicine we jumped over our heads too soon, introducing the (man made) diagnostic criteria based "nosological" system, which leads to premature ossification and codification of clinical concepts and experience, impeding the independent minded research greatly and precluding the normal development (albeit slow and lagging) of psychiatry as a medical science. Is it not more correct and probably clinically more productive, especially in the field of psychopharmacology, to return to syndromologically based classification system and to try to define, refine and research these historically formed clinical syndromes further, before rushing to judgements about their pseudonosological "pigeon holes"?
This is what Breivic trial, along with other issues, brings to the front. And these issues deserve a deep and long thought.
Michael Novakhov, M.D.
References and Links
Anders Breivik, the public, and psychiatry : The Lancet
Anders Breivik, the public, and psychiatry : The Lancet
The Lancet, Volume 379, Issue 9826, Pages 1563 - 1564, 28 April 2012
doi:10.1016/S0140-6736(12)60655-2
Cite or Link Using DOI
Cite or Link Using DOI 
via anders behring breivik - Google News on 4/28/12
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via anders behring breivik - Google Blog Search by jbaker on 4/28/12
Norwegian terror and mass murder defendant Anders Behring Breivik has issued an apology to the July 22 victims who he calls “innocent bystanders.
via anders behring breivik - Google Blog Search by Amaia Legeau on 4/28/12
During the third day of his trial, The Guardian reported how Breivik insisted that his goal (in the short to medium term) was to make pariahs of Europe's nationalists – the very people with whom you might expect him to feel ...
via anders behring breivik - Google News on 4/28/12
MiamiHerald.com | Norway Muslims question focus on Breivik's sanity Atlanta Journal Constitution By JULIA GRONNEVET AP OSLO, Norway — Muslim leaders in Norway say they are concerned that the anti-Islamic ideology of Anders Behring Breivik, the far-right fanatic now on trial for killing 77 people, is being overshadowed by questions about his ... Norway survivors of Breivik massacre tell of painChicago Tribune Experts: Norway mass killer Anders Behring Breivik likely not insane despite ...CBS News Experts: Mass killer Breivik likely not insaneMiamiHerald.com Detroit Free Press all 357 news articles » |
via anders behring breivik - Google News on 4/28/12
Norway Muslims question focus on Breivik's sanity Fremont Tribune AP | Posted: Saturday, April 28, 2012 7:42 am | (0) Comments Anders Behring Breivik arrives in court in Oslo Friday April 27, 2012 for the continuation of his trial. Since he has admitted his actions, Breivik's mental state is the key issue for the ... EUROPE NEWS AT 0700 GMTNECN EUROPE NEWS AT 1900 GMTKFOX El Paso all 16 news articles » |
via anders behring breivik - Google News on 4/28/12
 Salon | Europe's far right marches on Salon And in an Oslo courtroom, Anders Behring Breivik fights to prove he was sane last July when he systematically slaughtered 77 innocent people, mostly teenagers, at a summer camp. He was, he explains, simply trying to spark a crusade against ... and more » |
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