Matricide: An Integrated Medico-Legal and Forensic Psychiatric Analysis—A Case Report Series

Background and Clinical Significance: Matricide represents a rare and particularly complex form of intrafamilial homicide, situated at the intersection of forensic pathology, psychiatry, and criminology. Despite its major medico-legal implications, matricide remains insufficiently portrayed in the literature, especially regarding the correlation between injury patterns, mechanisms of death, and psychiatric profiles of perpetrators. This study presents four matricide cases investigated at the Institute of Forensic Medicine in Cluj-Napoca, Romania, highlighting their forensic and psychiatric heterogeneity. Case Presentation: A retrospective analysis of four matricide cases was performed using autopsy reports, histopathological examinations, toxicological findings, crime scene data, and forensic psychiatric evaluations. All victims were adult women killed by their sons in domestic settings. Fatal mechanisms included sharp-force cranio-cervical trauma with complete C2–C3 spinal transection, complex blunt cranio-maxillofacial trauma with cerebral destruction, mixed-mechanism mechanical asphyxia by manual strangulation and thoraco-abdominal compression, and acute respiratory failure caused by tracheo-broncho-pulmonary blood aspiration following facial trauma. Cranio-facial targeting predominated across all cases, while financial conflict represented the most frequent documented contextual factor (3 of 4 cases). Psychiatric findings ranged from dissocial personality disorder with preserved discernment to paranoid schizophrenia with absent discernment following treatment discontinuation. Simulation or deceptive behaviors were identified in two perpetrators. Conclusions: The presented cases illustrate the marked forensic and psychiatric heterogeneity of matricide, even within a limited regional series. The integration of detailed autopsy findings with forensic psychiatric evaluation provided a useful framework for reconstructing the mechanism of death, evaluating criminal responsibility, and interpreting post-offense behavior. These findings contribute additional empirical data to the limited literature on matricide and underline the importance of interdisciplinary medico-legal evaluation in intrafamilial homicide cases.