1. Home
  2. Articles


Abdulwahab F. Alahmari
Radiology Department, Al-Namas General Hospital, Ministry of Health, Al-Namas City, Saudi Arabia.

Article Info

Received Date: 21 June 2024, Accepted Date: 01 July 2024, Published Date: 05 July 2024

*Corresponding author: Abdulwahab F. Alahmari, Radiology Department, Al-Namas General Hospital, Ministry of Health, Al-Namas City, Saudi Arabia.

Citation:  Abdulwahab F. Alahmari (2024). “Madness”. International Journal of Case Reports and Case Research, 1(1); DOI: http;//

Copyright: © 2024 Abdulwahab F. Alahmari. This is an open-access article distributed under the terms of the Creative Commons Attribution 4. 0 international License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Unfortunately, madness is not a medical term and it has no equivalent medical term. The closest conditions are schizophrenia, bipolar disorder, and psychosis. Madness is a literary term to describe someone acting out of social norms or personal character. Since madness is not a medical term, there is no way of knowing if a mad person has a free will to commit a crime or if the criminal’s brain was impared from making a logical decision (Alahmari, 2024a; Alahmari, 2024b). Madness used to be thought to be the result of a spirit possessing. Many claim that a mad person has free will and consciousness, but they have no control over their behaviors, like OCD or Tourette syndrome patients (Alahmari, 2024c). Many people have claimed that some conditions cause absence of the mind, like schizophrenia, bipolar disorder, and psychosis. But why are other disorders like neurosis (i.e. severe anxiety and stress disorder) not considered madness? Someone who has severe neurosis might commit a crime due to being extremely angry, like in a road rage. Some patients who have hyperthyroism might become extremely mad due to being agitated and when they receive thyroixine, they become normal and describe themselves as crazy when they used to be sick. Some suggested an Intelligence Quotient (IQ) test to identify who is mad (i.e. crazy) and who is not. Some of the tested subjects scored 69% when they were in a bad mood and other times they scored >70%. If they score badly on the test on one day, they will be freed. If they scored a good score on the test, they will be punished. Let's say everyone takes the test seriously and this person scores 70%, the test result will have a range that changes, like 70% ± 5, that fluctuates according to the person's focus, concentration, mood, preparation, etc. For example, you tested this person this week and this person scored 70%. After one week, you test the same person and the score will be 68% because this person is in a different situation. How can anyone make a standard that does not

change for the same person? In order to carry justice! The criminals will not answer the questions in order to get a bad result, which makes the IQ test useless to identify who is mad and who is sane. Some criminals might act insanely in order to avoid punishment for major crimes like murder. How do you know that this criminal is faking it and that another convict is really insaine. If someone eats insects or defecates himself, people will think he is insane, but criminals can still fake it. The Rosenhan's experiment is a good example of psychiatry's ability to identify who is mentally ill and how they are acting (Alahmari, 2021). They went to mental institutions and claimed to hear the word "empty."

Women feel that they are crazy and describe themselves as “mad” or not being the same person when they have their menstrual period, pregnency, and manpousal. Temporary insanity is seen in many cases where “normal” people lose control of themselves and act crazy (Alahmari, 2024a; Alahmari, 2024b). Some people might act insane under certain conditions, like crimes of passion. That’s why the term insane or madness is an inclusive term that can be used in many contexts. Medical terms tend to be more specific about a certain condition to identify it and be able to separate it from close conditions. 

Being mentally drained leads to madness that causes a loss of free will, sense of agency, irrational behavior, and impaired judgment. Conciousness (i.e. senteince) can be imparied by delusions and hullcinations to be a transformative senteince (Alahmari, 2024d).

Free will might be impaired by some mental illnesses, but normal humans have moderate free will. Madness is completely crazy and lunacy is half crazy or someone who does idiotic things. Koch (2004) described lunatic as having a malfunction, damage, or atrophy in the locus coeruleus.

Madness needs to be measured with a yardstick. Madness
is measured by the average of normal people, but what is normal? Because normal is different in different societies, countries, cultures, regions, families, etc. Since nobody knows what is normal and how madness is compared with the normal. Madness is a spectrum and all humans have madness to a certain degree; some are too crazy and some are less crazy. Sometimes it is difficult to separate madness from genius.

Madness can be passive, like people who have a mental illness and are afraid of the public. Madness can be aggressive, like megalomania and mythomania, in mentally ill dictators who appear normal in public and speak in a logical and rational way. They hide their madness from the public, they might start wars, and convince the public with their crazy ideas.

Madness was used for political reasons when governments threw opposition party members into mental asylums for being mad (Foucault, 2003). Psychatric institutes used to love to control sick individuals and torture patients by jailing them and injecting them with morphine to keep them tranquilized, under their mercy and violating their human rights.

Since the mind is affected by mental, endocrine, and autoimmune brain disorders, madness can’t be limited to a few mental disorders like schizophrenia, bipolar disorder, and psychosis. Madness could be one of three things: 1) loss of free will and sense of agency (the Type 1), 2) altered reality (the Type 2), and 3) loss of the ability to be witness of itself consciousness or absence of the mind totally (the Type 3). The first type will be a lunatic, the second type will be delusional and someone suffers from hullucinations, and the third type will be someone who does not have a mental life and is not in a state of mental existence. Koob (2009) descripes glial cells to separate the humans from animals based on how many neuroglial cells humans have compared to them. If neuroglial cells were reduced in number and locus coeruleus were mal-fucntion or damaged, then this person might have an absence of mental life or be in a state of "madness." Other patients with schizophrenia or delusions have been indicated to have morphological changes in the brain, like agensis of the corpus callosum and other regions on neuroimaging scans, which indicate that a number of glial cells have been lost and as a result, this person has a lower number of glial cells, which resulted in abnormal, unexplained behaviors, but an intact locus coeruleus. Based on Koch's description of lunatics, someone with damaged locus coeruleus is considered Type 1, damaged glial cells of the brain are considered Type 2, and damaged locus coeruleus and glial cells are considered Type 3. Due to the low brain capacity of neuroglial cells, which is a biomarker that can be added to the clinical evaluation of a criminal with other psychological and behavioral monitoring, a strong conclusion can be drawn regarding someone's insanity (i.e. in the long term, not temporary insanity). Severe types of Neurosis (anxiety and stress disorder) and deminitia can fit into Type 1 madness. Bipolar disorder, schizophrenia, and psychosis can fit into Type 2 madness. Mental retardation and other conditions can fit into Type 3 madness. A list of conditions must be studied and classified into each type of madness. Other psychological and behavioral factors must be added in order to have a good understanding of what madness is.

This paper does not contradict other previously published papers (Alahmari, 2024a; Alahmari, 2024b) by the same author, which highlighted that there are no biological factors for crimes, but there are biological and non-biological factors for mental illnesses that might contribute to making this ill person commit a crime, but there are no biological factors per se for crimes.


  1. Alahmari AF. (2024a). Crimes and Neuroimaging: Essay Refuting the Biological Factors of Criminal Minds. Int J Forens Sci 2024, 9(1): 000360.
  2. Alahmari AF. (2024b). Crimes and Neuroimaging: Essay Refuting the Biological Factors of Criminal Minds Part II. Int J Forens Sci, 9(1): 000372.
  3. Alahmari AF. (2024c). Neurocrimnology and Free Will. Int J Forens Sci 2024, 9(1): 000387.
  4. Alahmari AF. (2024d). Epineural theory of consciousness: Two thought experiments and preliminary hypothesis. Unpublished manacript.
  5. Alahmari, A. (2021). Neuroimaging Role in Mental Illnesses. Int. J. Neural Plast, 4 (10.31579).
  6. Foucault, M. (2003). Madness and civilization. Routledge.
  7. Koch, C. (2004). The quest for consciousness: A neurobiological approach.
  8. Koob, A. (2009). The root of thought: unlocking glia--the brain cell that will help us sharpen our wits, heal injury, and treat brain disease. FT Press.