I can’t get no satisfaction, cause I try and I try and I try: towards a modern understanding of the concept of querulousness

Abstract

Our paper tries to categorize, along modern nosographic concepts, the problem of the so called querulousness, showing how the expression of querulous behaviour is determined by different psychopathological domains. These domains create a continuum, spanning from severe personality disorders or, quite seldom, primitive delusional syndromes, to conditions dominated by stressors or major life events in individuals otherwise not mentally ill. So, it is necessary to discard the old fashioned nosographic concept which considers querulousness and querulous paranoia – included among ICD persistent delusional syndromes – as the same diagnostic entity.

From an historical perspective about the issue of delusion and, more widely, about delusion and mental capacity, this paper examines the positions of different authors in order to support its introductory argument, also employing clinical vignettes. It gets to the conclusive issue, stating that querulousness should be diagnosed more properly and above all assessed along more modern forensic guidelines. In particular, we stress the issue of the relation between querulous behaviour and the competence to stand trial.

Our paper expresses some conclusions on the mental capacity and on the subject of competence to stand trial of querulants. It expresses also a special view on the judicial issues caused by the querulant’s capacity to stand trial, analysing what some legal systems state on this topic, in particular in countries where a common law approach is used. We suggest some legislative initiatives, following what we have discussed in the psychopathological and in the forensic fields, when coming across a well diagnosed querulousness case.