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From what i have read, i think many of them dont even qualify as insane. That is giving them too much credit, and shifts the blame. They are sociopaths, and they are just evil.
One killer (from germany i think, maybe england) said "You dont have tio be crazy to be evil".
They know right from wrong, that is why they try to keep hidden. They just dont care. They give in to impulses that many normal people have but ignore or supress.
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