Criminal acts perpetrated by persons with mental disorders may not occur frequently, but they frequently make news. In 1995, the murder of sportscaster Brian Smith by a person with paranoid schizophrenia resulted in 72 recommendations by a coroner’s jury, including a comprehensive review of the Mental Health Act (1). Recently, a coroner’s jury heard the case of Lucia Piovesan of Hamilton, who stabbed Zachary Antidormi, age 2 years, to death. Piovesan, who has paranoid schizophrenia, believed the spirit of her dead son could be reborn if he were freed from Zachary’s body (2). A charge of assault against Piovesan had been dropped 6 months before the stabbing, despite an attempt by Zachary’s mother to stop the harassment through the criminal justice system (3). Piovesan was subsequently found not criminally responsible for the murder (2).

In Canada, antistalking legislation was enacted in 1993 (Note 1, 4), with the general intention of protecting women who had separated from abusive spouses, but it has also been used in

Manuscript received December 1999, revised, and accepted September 2000.
¹Assistant Professor of Psychiatry, University of Western Ontario, London, Ontario; Clinical Director/Psychiatrist in Chief and Director of Research, North Bay Psychiatric Hospital, North Bay, Ontario.
²Research Assistant, Medical Education and Research, North Bay Psychiatric Hospital, North Bay, Ontario.
³Formerly, Research Student, Medical Education and Research, North Bay Psychiatric Hospital, North Bay, Ontario.
Address for correspondence: Dr SJ Adams, Box 3010 Ministry of Health, North Bay Psychiatric Hospital, Hwy 11 N, North Bay, ON P1B 8L1
e-mail: sadams@onlink.net

cases where criminal harassment stems from mental disorder. In 1996 the Canadian Justice Department funded a study to review the functioning of this statute by sampling data from police and crown case files in selected cities (5). Some evidence arising from this study suggests that this legislation may not be used effectively, even in dealing with the perpetrators for whom it was specifically designed. Despite the repetitive nature of criminal harassment, 81% of accused were given a pretrial release—including the 55% of offenders with a history of repeatedly breaching such orders. Of cases reviewed, 57% involved a former or current partner. Only 14% of the offenders were identified as suffering from a psychological problem.

Erotomania has been associated with stalking behaviour, although it only accounts for some cases (6). Erotomania is a delusional syndrome that can manifest as part of the symptomatology of other frequently paranoid disorders (7). Mullen and Pathe describe 14 erotomanic patients, all of whom stalked and harassed the object of their love (8). The police were at some point involved in each case, with criminal charges resulting in all but 2 cases. There were 5 incidents of threatening, 7 incidents of sexual attack, and 5 instances of violent assault—1 resulting in death. There were 5 patients with delusional disorder, 7 with schizophrenia, 1 with bipolar disorder, and 1 with organic psychosis.

In a more recent study, Mullen and others evaluated 145 stalkers referred for forensic evaluation (9). Of the sample,