Lashwan Thompson’s body was found, totally covered in bed bugs, inside a cell in the psychiatric wing of the Atlanta prison in Georgia. The Fulton County Medical Examiner’s Office ruled the cause of death as undetermined. The report listed Schizoaffective Disorder, Bipolar Disorder, and the acute exacerbation that Thompson was suffering from as “other conditions.” Lashwan had been in custody on misdemeanor assault charges since June 2022 and was housed in the psychiatric wing of the prison due to his mental health issues. We asked our Profiler, Dr. Cristina Brasi, to give us a picture of Thompson’s psychic situation.
Schizoaffective disorder would represent a sort of bridge between schizophrenia, in which delusions and hallucinations are present, and mood disorders. Specifically, Thompson’s mood disorders would appear to be attributable to bipolarity, including manic episodes alternating with major depressive episodes. However, the alternation between manic and depressive phases would always occur in association with psychotic symptoms, while psychotic symptoms would also appear outside the humoral phases. During the major depressive episode the mood would be extremely low for most of the time, to the point of significantly compromising all areas of daily life due to the loss of interest and pleasure in carrying out everyday activities. You may experience weight changes, sleep disturbances, feelings of worthlessness and guilt, impaired ability to concentrate, thoughts of death and suicidal ideation. During the manic episode, however, the mood would be persistently high, expanded in exaggerated and inappropriate ways, with unlimited enthusiasm for social and work interactions, there would also be an increase in energy and daily activities. The predominant mood would often turn out to be alterable and characterized by an alternation between euphoria and irritability. Depressive or manic symptoms may occur before the onset of psychosis, during psychotic episodes, and after cessation of psychosis. The elements attributable to the schizophrenic disorder would compete with delusions and hallucinations. Delusions are fixed or overtly bizarre ideas based on misperceptions that the individual believes despite evidence that they are irrational. Hallucinations, on the other hand, are vivid and clear perceptions that occur without a real external stimulus, without the voluntary control of the person experiencing them and in the context of a healthy sensory system. Thought and speech are disorganized so we may find incoherence, inadequate responses, echolalia (automatic repetition of other people’s sounds and words), derailment and schizoaphasia (a dissociated language that is articulated with incomprehensible words). There would also be a decrease in expressiveness and affectivity, abulia and anhedonia (lack of interest and pleasure in undertaking normal daily activities), asociality, abnormal motor behavior and mutism, up to catatonia, or a marked reduction in responsiveness to external stimuli.
Dr. Denise Gemmellaro, entomologist and professor of forensic science at Kean University (USA), has framed the characteristics of bed bugs and their real effects on health. “Bed bug adults are approximately 5mm, oval in shape, however, after feeding, their size and body weight can increase significantly. They are attracted by the heat of the human body and by the carbon dioxide emitted during respiration; these elements allow the insect to locate the host and for this reason they are very commonly found in beds. They mainly feed at night, while during the day they often remain hidden; with their mouthparts they pierce the skin of the host and at the same time suck blood and inject vasodilatory and anticoagulant substances to facilitate its exit. Their bites are usually painless and you only notice them after the bedbug has completed its meal and moved away. From the literature, specifically from a review by Dr. Goddard and Dr. deShazo (2009), it is clear that bedbug bites often do not give any reaction; when a reaction is present, it is cutaneous, often associated with itching, and generally resolves within a few days. Systemic reactions (asthma, urticaria and anaphylaxis) have been documented, but again these are individual case reports. There are data on the transmission of diseases by bedbugs, but it is not clear whether the pathogens assimilated by these insects through the blood they feed on are able to replicate within their digestive system, and whether these can then be found in they did. It would appear that there is not enough data to evaluate the effects that bed bugs can have on human health; the available publications report single cases, in the cases of multiple subjects exposed to their bites, only about 30% of these develop clinical reactions, often cutaneous. The greatest impact that these insects would seem to have on humans therefore appears to be non-medical, but connected to the social and hygienic contexts in which the subjects exposed to their bites live.”
The consequences in terms of mental health would be different. According to research (Ashcroft et al., 2015) conducted on a sample of 51 scientific articles related to the psychic effects related to bed bug infestations, including severe psychiatric symptoms, it would seem likely that there are mental health consequences for those who have been affected by this type of infestation. Insects might evoke, in some individuals, a sense of anguish, fear, anxiety, an increased heart rate, and impaired functioning. It has been found that bed bug infestations could lead to consequences such as nervousness, anxiety and insomnia. Symptoms of psychological distress could manifest as an acute reaction to a stressful situation. When an individual is able to cope with the uncomfortable situation, these symptoms would be transient allowing the subject to return to normal functioning. In vulnerable populations, such as individuals genetically predisposed to mental illness or with additional psychosocial stressors, these symptoms may progress to more severe psychiatric manifestations such as aggression, psychosis and/or suicidal behaviour. The stressor, specifically the haunting, could also act as a precipitating or perpetuating factor in the onset or worsening of diagnosed psychiatric disorders.
Exposure to bed bug infested environments has been reported to be associated with a variety of psychological consequences. Among the publications analysed, 54.9% reported psychological discomfort and stress caused by the bites, as well as nightmares and flashbacks resulting from the infestation. 50.9% of victims of frequent bed bug bites would have developed a series of psychological and behavioral symptoms including sleep disturbances, insomnia, mood swings, nervousness, panic, agitation, hypervigilance (to keep the insect away from their body), delusion, PTSD (Post Traumatic Stress Disorder)-like symptoms, and socio-occupational dysfunction. In 74.5%, persistent and chronic bed bug infestations would have triggered the onset of psychiatric symptoms or disorders including anxiety, depression, PTSD, phobia and psychosis even in those who did not appear to be affected by psychiatric psychopathology. Bed bug infestations also cause worsening of pre-existing conditions in some patients with bipolar disorder, schizophrenia, depression and anxiety, such as Thompson’s case. The most worrying element would concern the fact that bed bugs could increase the risk of suicide, as well as exacerbate cognitive disorders and serious or persistent mental illnesses, as the subject victim of the infestation may not possess the necessary skills to faced with this condition.