The Role of Interpersonal Conflict as a Determinant of Firearm-Related Homicide-Suicides at Different Ages

Elderly abuse - a forensic case of homicide-suicide as act of intimate partner violence

Homicide-suicide as a criminal act is a distinct subcategory of homicide in which the assailant kills his wife and/or her children in a relationship that has been broken down. The present case is about the dyadic deaths of an 89-year-old male and an 82-year-old female who are in a relationship as intimate partners (as husband and wife). In the early autumn of 2020, an event report was received in the Police District of Plovdiv about a woman who was found dead in her home. Her husband's body was found next to hers in the same building, with the clinical features of a coma - the man was breathing but unresponsive. Unfortunately, he passed away immediately before the arrival of the emergency crew.

A systematic review of the co-occurrence of self-harm and aggression: Is dual harm a unique behavioural construct?

Introduction

Dual harm is the co-occurrence of self-harm and aggression during an individual's lifetime. It is unclear whether sufficient evidence exists for dual harm as a unique clinical entity. This systematic review aimed to examine whether there are psychological factors that are uniquely associated with dual harm when compared to those who have engaged in sole harm (self-harm alone, aggression alone) and no harmful behaviours. Our secondary aim was to conduct a critical appraisal of the literature.

Methods

The review searched PsycINFO, PubMed, CINAHL, and EThOS on September 27, 2022, resulting in 31 eligible papers that represented 15,094 individuals. An adapted version of the Agency for Healthcare Research and Quality was used to assess risk of bias and a narrative synthesis was conducted.

Results

The included studies assessed differences in mental health problems, personality, and emotion related factors between the different behavioural groups. We found weak evidence that dual harm is an independent construct with unique psychological characteristics. Rather, our review suggests that dual harm results from the interaction of psychological risk factors that are associated with self-harm and aggression.

Discussion

The critical appraisal identified numerous limitations within the dual harm literature. Clinical implications and recommendations for future research are provided.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=197323, identifier CRD42020197323.

Vulnerable individuals and changes in suicidal behaviour during the COVID-19 pandemic in Korea

BACKGROUND

The COVID-19 pandemic poses a major threat to mental health and is associated with an increased risk of suicide. An understanding of suicidal behaviours during the pandemic is necessary for establishing policies to prevent suicides in such social conditions.

AIMS

We aimed to investigate vulnerable individuals and the characteristics of changes in suicidal behaviour during the COVID-19 pandemic.

METHOD

We retrospectively reviewed the medical records of patients with suicide attempts who visited the emergency department from February 2019 to January 2021. We analysed the demographic and clinical characteristics, risk factors and rescue factors of patients, and compared the findings between the pre-pandemic and pandemic periods.

RESULTS

In total, 519 patients were included. During the pre-pandemic and pandemic periods, 303 and 270 patients visited the emergency department after a suicide attempt, respectively. The proportion of suicide attempts by women (60.1% v. 69.3%, P = 0.035) and patients with a previous psychiatric illness (63.4% v. 72.9%, P = 0.006) increased during the COVID-19 pandemic. In addition, patients' rescue scores during the pandemic were lower than those during the pre-pandemic period (12 (interquartile range: 11-13) v. 13 (interquartile range: 12-14), P < 0.001).

CONCLUSIONS

Women and people with previous psychiatric illnesses were more vulnerable to suicide attempts during the COVID-19 pandemic. Suicide prevention policies, such as continuous monitoring and staying in touch with vulnerable individuals, are necessary to cope with suicide risk.

Is Homicide Followed by Suicide a Phenomenon in Itself? A Comparison of Homicide and Homicide-Suicide in Spain

The phenomenon of homicide followed by suicide (HS) has a low prevalence worldwide, although the literature has identified that these cases represent a significant percentage in homicide subtypes such as intimate partner homicide or filicide. In the present study, HS (n = 41) and homicides in which the perpetrator did not commit suicide after the event (n = 556) are compared. The information was extracted from police reports of homicides committed in Spain between 2010 and 2012 and belonging to the jurisdictions of the National Police and Civil Guard. The results showed that out of the total number of homicides analyzed, HS accounted for 4.9%, which implies a rate of 0.05 per 100,000 inhabitants. The findings of the study show that the profile of a HS victim of a 52-year-old Spanish woman. The perpetrator is of Spanish origin, 50 years old, unemployed, or retired, with a mental disorder, and with substance use being uncommon at the time of the event. HS events take place at the perpetrator's home, are related to interpersonal conflicts, involve a single perpetrator, several victims, and are mainly committed with a firearm. The findings are mostly consistent with previous studies and the prevalence of HS in the couple setting is highlighted (56.5%). However, the importance of studying cases outside of this setting is emphasized since it has been found that 30.5% of cases involve other family relationships and 13% occurred outside the domestic sphere.

Association of mental disorders with firearm suicides: A systematic review with meta-analyses of observational studies in the United States

In the United States (US), 61% of all suicide cases may involve firearms, and some evidence suggests that mental disorders may play a role in suicide by firearm. We performed the first systematic review and meta-analyses to investigate: (i) whether mental disorders are associated with suicide by firearm, and (ii) whether the risk of using a firearm compared with alternative means is associated with higher levels of suicide in individuals with a mental disorder METHODS AND FINDINGS: We searched twelve databases from inception to the 24th of May 2020. We retrieved 22 observational studies conducted in the US. Random-effects meta-analyses showed individuals who had a diagnosis of a mental disorder had lower odds (odds ratios (OR)= 0.50, 95% CI: 0.36 to 0.69; I²=100 (95% CI: 87 to 100%), of dying by suicide with a firearm than those who did not have a diagnosis of a mental disorder. Secondary analysis showed that decedents who had a mental health diagnosis resulted in lower odds of dying by suicide by using firearms than using other means LIMITATIONS: Risk of bias revealed a heterogeneous and poor definition of mental disorders as well as lack of control for potential demographic confounding factors. In the meta-analyses, studies were combined in the same analytic sample as 77% of these studies did not specify the type of mental disorder CONCLUSION: While our results seem to suggest that having a mental disorder may not be consistently associated with the odds of dying by suicide using a firearm, the presence of substantial heterogeneity and high risk of bias precludes any firm conclusions.

Understanding Homicide-Suicide

Homicide-suicide is the phenomenon in which an individual kills 1 or more people and commits suicide. Research on homicide-suicide has been hampered by a lack of an accepted classification scheme and reliance on media reports. Mass murder-suicide is gaining increasing attention particularly in the United States. This article reviews the research and literature on homicide-suicide, proposing a standard classification scheme. Preventive methods are discussed and sociocultural factors explored. For a more accurate and complete understanding of homicide-suicide, it is argued that future research should use the full psychological autopsy approach, to include collateral interviews.