Incidence and risk factors of homicide-suicide in Swiss households: National Cohort study

Murder-suicides in Milan: case history from 1990 to 2018. Criminological and medico-legal considerations

This study reviews autopsies performed by the Legal Medicine department of the University of Milan from 1990 to 2018. In particular, the characteristics of the perpetrator, the victim and the type of existing relationship, the means used, and the place and time of the crime. A retrospective analysis was conducted, extracting data from the Milan Institute of Legal Medicine database, selecting cases of murder-suicide from the archive between 1990 and 2018 (a total of 75 cases with 84 murder victims). Available data was processed statistically. Univariate and bivariate analysis techniques were mainly used. Significance tests (Chi-square) and correlation studies (Pearson's R) were also conducted, the results of which were then examined and discussed in light of legal, medical and criminological expertise.In almost all cases, suicide followed immediately after the murder, at home and in the context of an emotional relationship. The murderer and person committing suicide is almost always male and the victim female. A firearm was the most common weapon in cases of both murder and suicide.The results indicate that the issue of gender is relevant in murder-suicides as indicated by international and national literature on homicides. Furthermore, the use of firearms endorses the importance of limiting their availability through more restrictive laws.

Prevalence of Homicide-Suicide Incidents in Greece over 13 Years

Prevalence of homicide-suicides is difficult to determine in Greece due to the lack of a national tracking system. The aim of this study was to estimate the prevalence of the homicide-suicide incidents in Greece over the past 13 years, and to determine the circumstances under which they occurred, as well as the characteristics of perpetrators and victims. Two Internet search engines (google and yahoo), as well as the search engine of the major national news websites, were surveyed to identify the number of homicide-suicide cases that occurred in Greece from January 2008 to December 2020. Over the study period, 36 homicide-suicide incidents occurred in Greece, resulting in 36 suicides and 41 homicides. The above incidents reflect an annual homicide-suicide rate of 0.02 cases per 100,000 inhabitants. Most perpetrators were male (88.9%), whereas most victims were female (80.6%). Spousal-consortial cases accounted for 52.7% and familial cases for 41.7% of the total number of incidents. The use of firearms (mostly shotgun) was the most common method of homicide and suicide (58.3% and 63.9%, respectively). Women killed only their children, while men committed homicide and suicide mainly in the context of a former or current intimate partnership with the victim. Our results are in line with international homicide-suicide data. The establishment of a national surveillance system for homicides-suicides would be of paramount importance as it would facilitate accurate recording, identification of risk factors and characteristics of potential victims and perpetrators and it could ultimately be an aid to the prevention of such tragic events.

Intimate Partner Violence against Women Living in Inadequate Conditions in Sub-Saharan Africa: A Meta-Analysis of Demographic and Health Survey Data

Intimate partner violence (IPV) against women is a major public health problem and is widespread in sub-Saharan Africa (SSA). However, little is known about its environmental determinants. This study aimed to investigate whether inadequate living conditions are associated with IPV victimization in women in SSA. We analyzed cross-sectional data for 102,714 women in 25 SSA countries obtained from the Demographic and Health Surveys Program. Logistic regression was used to estimate the country-specific effects of inadequate living conditions (housing with at least one of four characteristics of unimproved water, unimproved sanitation, insufficient space, and unfinished materials) on multiple forms of IPV. Random effects meta-analysis was used to combined the country-specific estimates. We found an association between inadequate living conditions and a higher likelihood of experiencing any (OR = 1.12, 95% CI 1.03 to 1.23, p = 0.012), sexual (OR = 1.18, 95% CI 1.05 to 1.34, p = 0.008), emotional (OR = 1.12, 95% CI 1.02 to 1.23, p = 0.023), and physical (OR = 1.15, 95% CI 1.03 to 1.28, p = 0.010) IPV. The associations were stronger for rural and less-educated women. These findings suggest that future research to establish a causal link between living conditions and IPV and to elucidate the underlying pathways is crucial to design IPV interventions in SSA.

Identification of socio-demographic, occupational, and societal factors for guiding suicide prevention: A cohort study of Swiss male workers (2000-2014)

INTRODUCTION

We modeled suicidal rate among Swiss working-age males, considering three groups of factors at socio-demographic, occupational, and societal levels jointly. Our goal was twofold: to verify the effect of occupation after adjustment for non-occupational factors and to identify protective and risk factors relevant for suicide prevention in working male adults.

METHODS

The study population included all men aged [18-65] years at the 2000 population census and followed up within the Swiss National Cohort (SNC). The risk of suicide was modeled using Poisson regression.

RESULTS

The cohort comprised 1,534,564 men and 4371 deaths by suicide. Suicide rate varied significantly according to age, civil status, nationality, highest education achieved, and socio-professional category at socio-demographic level; occupation, occupational activity branch, weekly working hours, and home-to-work commute time at occupational level; calendar period of death, region, religious affiliation, and volunteering activity at societal level. After adjustment for non-occupational factors, agricultural and fishery laborers, military and civil security workers, and health and social workers were identified as high-risk groups with respect to suicide.

CONCLUSION

This study evidenced a complex web of factors at socio-demographic, occupational, and societal levels behind the suicide in Swiss male workers and identified the most at-risk groups, deserving targeted prevention efforts.

Typology of murder-suicides in Berlin according to a longitudinal study based on autopsy files

Murder-suicides are defined as the murder of at least one person and the suicide of the offender following the murder. The intention to commit suicide must be primary. In most cases, a male offender kills a female victim after a separation. The current analysis was the first analysis of the typology of murder-suicides in Berlin. We analyzed the autopsy files of the Institute for Forensic Medicine of the Charité University Medicine Berlin and of the City Institute for Forensic Medicine Berlin. We performed descriptive and statistical analyses of cases between 2005 and 2013. We identified 17 murder-suicides. All 17 offenders were male, and 20 of the victims (90%) were female. The offenders used firearms in the majority of the cases. In seven cases, the victims and offenders were at least 80 years old. The average age of the offenders was 63 years. Disease was the motive in 6 cases involving older offenders. Our study might support the development of prevention strategies. In this regard, it is important to build a database for murder-suicides in Germany and other countries, to formulate a uniform definition of murder-suicide, to carry out nationwide interdisciplinary studies on this topic and to improve the existing health care structures, especially for older adults and people with depression.

Association between Household Crowding and Violent Discipline and Neglect of Children: Analysis of Multiple Indicator Cluster Surveys in 26 Low- and Middle-Income Countries

The influence of household crowding on physical and mental health has been well documented. However, research on the influence of household crowding on violent discipline and neglect of children is scarce. Therefore, we aimed to investigate whether household crowding was associated with violent discipline and neglect of children in low- and- middle-income countries (LMICs). Cross-sectional data for 280,005 and 73,030 children in 26 LMICs surveyed using the Multiple Indicator Cluster Survey were analyzed for (1) violent discipline and (2) neglect, respectively. In each country, we used logistic regression models to estimate the effects of household crowding on multiple forms of violent discipline and stimulation activities (as a proxy of the level of child neglect). Estimates were pooled using random effects meta-analyses. After adjusting for confounding variables, household crowding was associated with higher odds of any violent discipline (odds ratio (OR) = 1.09, 95% CI 1.03 to 1.15, p = 0.002) and lower odds of engaging in four or more stimulation activities (OR = 0.88, 95% CI 0.83 to 0.94, p < 0.001). The associations were stronger for urban children and children living in low- and lower-middle-income countries. The findings suggest that screenings and interventions aimed at reducing the effects of household crowding might be effective in preventing and controlling violent discipline and neglect of children in LMICs.

Violent deaths among elderly in Attica, Greece: A 5-year survey (2011-2015)

According to World Health Organization (WHO) estimations, approximately 6 million people lose their lives yearly due to some kind of injury, while one-third of these incidents are due to violent acts. Violent deaths include accidents (road traffic accidents, drownings, falls, heat effects etc), suicides as well as homicides. Elderly people seem to be at greater risk due to their special characteristics as a vulnerable social group. The aim of this study was to investigate violent deaths (accidents, suicides and homicides) among elderly people in Attica, Greece, during the period 2011-2015 by examining manner of death with respect to demographic data (gender and age) and toxicological examination results. A total of 546 violent deaths among people over 65 years old were included in this study. Autopsy findings along with toxicological examination results were collected from the archives of the Department of Forensic Medicine and Toxicology of the National and Kapodistrian University of Athens. The findings of the study showed that most of the victims were male (63.74%). The overwhelming majority of violent deaths (425 cases) were accidents, 92 cases suicides, and the remaining 29 cases homicides. Drowning was the leading cause of all accidental deaths, followed by road traffic accidents. Hangings prevailed among violent suicide methods and asphyxiation presented as a predominant homicide method.

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

Although firearm-related homicide-suicides and firearm-related suicides are tragic and catastrophic events, there is increasing evidence that the two events have different precipitants and that understanding these precipitants may help prevention efforts. We aimed to assess the role of interpersonal conflict (IPC) and recent crises in firearm-related homicide-suicides as compared with firearm-related suicides alone. We also assessed whether these differences were consistent across young and old perpetrators. Using an unmatched case-control study, we compared firearm-related homicide-suicides andsuicides alone from 2003 to 2011 in the National Violent Death Registry data to assess the risk associated with IPC and crisis. Survival analysis was performed to compare time-to-incident of homicide-suicide versus suicide only. We derived odds ratios (ORs) and 95% confidence intervals (95%CI) due to IPC and recent crisis from mixed logistic regression models. Stratified analysis by age on the effect of IPC and recent crisis, and type of incident was also performed. After adjusting for relevant covariates, homicide-suicides were more likely than suicide alone following IPC (OR = 20.6, 95%CI = [16.6, 25.7]) and recent crisis (OR = 14.5, 95%CI = [12.4, 16.9]). The risk of firearm homicide-suicide compared with suicide associated with IPC was twice greater among those >30 years compared with those ≤30 years ( p-interaction = .033), and no differential by age associated with recent crisis ( p-interaction = .64). IPC and recent crisis are risk factors for committing homicide-suicides compared with suicides alone, with the risk doubly greater among older than younger perpetrators.