Homicide followed by suicide: a comparison with homicide and suicide

A special type of homicide-suicide: A retrospective study of the characteristics of extended suicide

Extended suicide, a specific type of homicide-suicide event, has severe social consequences yet remains lacking systematic research. This retrospective study investigated 51 cases of extended suicide involving mental disorders in central China with aim of better understanding risk factors for such events and guiding prevention strategies. Over an 8-year period from 2015 to 2022, cases were collected from forensic institutions, and demographic characteristics, case details, and psychiatric data were recorded. The 51 incidents involved 51 perpetrators and 79 victims, with more female perpetrators (58.8%) and more female victims (54.4%). The average age of the perpetrators was 36.1, and most were married (88.2%). Almost all of the victims were family members of the perpetrator, like the most numerous children (64.6%), followed by spouses (24.1%). The most common homicide mode of death was mechanical asphyxia (38.0%), followed by sharp devices (36.7%) and drug poisoning (16.5%). Depressive disorders (76.5%) were the most common diagnosis of mental disorder for perpetrators. The study analyzed the unique characteristics of extended suicide to enrich such data. These findings help strengthen the screening and identification of potential perpetrators and victims to prevent such cases from occurring.

A Descriptive Study of the Characteristics of Homicide-Suicide in Forensic Autopsy Cases

Homicide followed by suicide (HS) is a tragic event with varied characteristics across countries and regions. Compared to Western countries, there are limited studies on HS in Asian countries. Therefore, this study aimed to clarify the characteristics of recent HS cases by examining forensic autopsy records from 2008 to 2020 collected from the Department of Legal Medicine, Chiba University, in Japan. A total of 77 HS cases were identified, involving 77 perpetrators (52 completed suicides, 25 attempted suicides), with 28 perpetrator and 89 victim autopsies. Our findings showed that older adults accounted for nearly half of the victims; victims were mostly females, whereas most perpetrators were male. The most common HS relationship was that between a parent and a child. Autopsy findings showed that the most common cause of death was strangulation, and illegal drugs were detected only in a few cases; however, psychotropic drugs were detected in child victims. No obvious evidence of past child physical abuse by caregivers was found. In contrast, intimate partner violence (IPV) was present, with a history of IPV found in half of HS cases involving adult intimate partner relationships. Notably, gender differences in age and relationship to the victim were identified. Likewise, some perpetrators may have expressed their plans and intentions for HS before the event, which may represent an important sign for HS prevention. However, to accurately reveal the course of HS, nationwide integrated statistics, forensic autopsies, including toxicological analyses of the deceased; and forensic psychiatric perspectives, including psychological autopsy, are required.

In the Name of Love or Hatred: a Systematic Comparison Between Filicide-Suicide and Mariticide/Uxoricide-Suicide in Hong Kong

While much of work on homicide-suicide (HS) arises out of the USA and the UK, there is a paucity of research on HS outside of the Anglo-American sphere. This paper investigates HS in Hong Kong (HK), comparing the subtypes of filicide-suicide (FS) and mariticide/uxoricide-suicide (MUS) in that context as a means of testing the generalizability of past studies. Data from the HK Special Administrative Region (HKSAR) government and the HK Police Force reports retrieved 156 cases from 2000 to 2019. In that timeframe, HS resulted in 261 deaths, with MUS being the most prevalent type of HS. Male offenders and female victims are more commonly seen. Offenders are generally older than their victims, and over half of offenders are married. FS and MUS display distinct characteristics in terms of offender and victim demographics, relationship dynamics, motives, and mode of killing. Depressed mothers tend to victimize their sons in FS as a means of saving their sons from a perceived miserable future, whereas male offenders aggress upon their female partners in MUS to alleviate their own frustrations, subsequently dying by suicide out of sorrow or a fear of consequence. MUS offenders are more hostile towards their victims and tend to kill with aggressive means, whereas FS offenders are more likely to kill with altruistic motives and with minimal force. These results match patterns of MUS and FS in the Anglo-American sphere, but with some important differences in terms of the use of guns and the presence of altruistic killing.

Analyzing two decades of intimate partner femicide-suicides in Türkiye

Intimate partner femicide-suicide (IPF-S) is an understudied subgroup of homicide-suicide deaths. Limited research has been conducted on IPF-Ss in the Eastern Mediterranean region. This study thus aimed to evaluate the characteristics of IPF-Ss that occurred in Türkiye between 2000 and 2019. IPF-Ss (n = 226) were extracted from electronic news stories. Data on victims, perpetrators, their relationships, and incidents of murder and suicide were collected. Descriptive statistics were calculated, and logistic regression analysis, mortality rates, and proportion of IPF-S in femicide calculations were conducted, showing that 13.3% of the femicides (n = 1699) were IPF-Ss. The IPF-Ss increased in 5-year intervals and were the highest during the 2015-2019 period (62.5%). Victims were married in 48.2% of the cases and 56% were aged <35 years, while 51.3% of the perpetrators were married and 52.6% were aged >40 years. In 42.0% of the cases, the perpetrator lived with the victim. Most (79.2%) of the cases took place in urban settlements, and the perpetrators used firearms in 84.1% of femicide cases. Firearm use was the most common method in cases where IPF-S was planned (OR = 2.98), when the IPF-S method was the same (OR = 29.6), and when the perpetrator committed suicide (OR = 7.82). In addition, it was found that firearm ownership is an important risk factor for IPF-S in Türkiye. Therefore, we recommend legislation to restrict firearms, as well as new measures to prevent illegal access to weapons.

A comparative analysis of solitary suicides, suicides following homicide, and suicide pacts using the National Violent Death Reporting System

BACKGROUND

Incidents of suicide can be categorized into three main types: solitary suicides, suicides following homicide, and suicide pacts. Although these three suicide incidents vary by definition, no studies to-date have simultaneously examined and compared them for potential differences. The objective of the current study was to empirically and descriptively compare solitary suicides, suicides following homicide, and suicide pacts in the United States.

METHODS

Restricted-access data from the National Violent Death Report System for 2003-2019 for 262,679 solitary suicides, 4,352 suicides following homicide, and 450 suicide pacts were used. Pairwise comparisons of the three suicide incident types were made for demographic factors, method of suicide, preceding circumstances, mental health status, and toxicology findings.

RESULTS

Solitary suicides, suicides following homicide, and suicide pacts have distinct profiles, with statistically significant (p < 0.05) differences across all pairwise comparisons of sex, race, ethnicity, marital status, education, method of suicide, financial problems, interpersonal relationship problems, physical health problems, mental health problems, mood disorders, suicide attempt history, and opiate use at the time of death.

CONCLUSION

Despite sharing a few commonalities, solitary suicides, suicides following homicide, and suicide pacts represent distinct phenomena. Each of these suicide incident types likely have their own unique prevention pathways.

Do Homicide Perpetrators Have Higher Rates of Delayed-Suicide Than the Other Offenders? Data from a Sample of the Inmate Population in Italy

Homicide-suicide can be defined as homicide followed by the suicide of the perpetrator shortly afterward. In the so-called "homicide-delayed suicide", homicide and suicide occur but within a wide and not strictly defined timeframe. This study analyzes data concerning the suicide of 667 inmates in Italy between 2002 and 2015, considering homicide perpetrators compared to all offenders. The analyses revealed that inmates who had committed homicide were more likely to commit suicide (71% versus 45%; χ2 = 10.952, p = 0.001) and the odds of suicide increase concerning 1.58 times among homicide perpetrators. The time-to-suicide interval after homicide ranges between 0 to 9.125 days (mean = 1.687,9; SD = 2.303,1). Moreover, the intimate-homicide offenders who committed suicide had a significantly shorter survival time after the offense than did the other non-intimate offenders who died by suicide (t test, t = -3.56, df = 90, p = 0.001). The link between homicide and higher suicide risk in homicide perpetrators should be highlighted because of all the homicide offenders passing through the criminal justice system. Superior knowledge about the path of homicide-delayed suicide will be of particular use to professionals in evaluating and treating homicide inmates.

Incomplete homicide-suicide in Hunan China from 2010 to 2019: characteristics of surviving perpetrators

BACKGROUND

The mental and psychological conditions of the individuals involved in homicide followed by suicide (H-S) are still unclear, especially in China. Information on these aspects cannot be accurately obtained due to the death of perpetrators. This study aims to demonstrate the characteristics of incomplete H-S with surviving perpetrators, which provide the possibility to obtain detailed mental and psychological information.

METHODS

This study explores incomplete H-S events occurred in Hunan, China from 2010 to 2019, in which the surviving perpetrators received a forensic psychiatric assessment. Three aspects of information, i.e., the subject's demographic, clinical and criminal information, were recorded and analysed.

RESULTS

125 incomplete H-S incidents involved 166 victims were found in the current study. A total of 112 (89.6%) perpetrators were diagnosed with mental disorders, but only 56 of them had a history of consultation due to mental problems, and only one of them adhered to treatment. In most cases, the motivation is related to the psychopathological states, with the most common diagnosis being major depression, followed by schizophrenia. Gender difference was significant among the subjects: females were more likely to have a suicidal history, to be diagnosed as major depression and to be motivated by delirious altruism and family problems.

CONCLUSIONS

This study indicated that psychopathology might be a predisposing factor, which highlighted the importance of mental state assessment for the population involved in incomplete H-S. A clearer understanding of the role of mental disorders might be helpful for the intervention of H-S.

Familicide: A Systematic Literature Review

Familicides have received relatively little attention and are mostly discussed in studies with broader aims. Here, we reviewed 67 studies from 18 countries on familicides, in which an offender killed or attempted to kill their current or former spouse/intimate partner and one or more of their biological or stepchildren. We conducted a systematic literature search in PubMed, PsycINFO, and Google Scholar. Eight studies investigated familicide specifically, while the remaining reported on familicide cases as a subsample. We retrieved data on offenders' gender, age, and background as well as on victims and their relationship to the offender. We also retrieved data on contextual factors and offense characteristics (i.e., modus operandi, offense location, premeditation, and whether or not the offender had committed suicide). We also coded methodological aspects of the studies. Familicides were almost exclusively committed by men and about half of the familicide cases led to the suicide of the offender. Mental health problems, relationship problems, and financial difficulties were prevalent. Because few studies reported population base rates of the investigated characteristics, it is difficult to draw conclusions about specific risk factors. Future research should further investigate typologies of familicide and examine risk factors for different types of familicides.

Australian Mass Shootings: An Analysis of Incidents and Offenders

Mass shooting events are relatively underresearched, and most study comes from the United States. Despite significant international interest, little is known about other countries' experiences of these events. The current study examines Australian mass shooting incidents and offenders, with emphasis on mental illness, life strains, and offenders' life histories. Australia had 14 mass shootings between 1964 and 2014. Most offenders experienced acute life stressors and/or chronic strains leading up to the event; however, diagnosed mental illness was less commonly documented. These observations provide new information about mass shooting incidents and offenders, and can help to inform international policy development.

Characteristics of Intimate Partner Homicide in China: Compared With Previous Studies in Other Countries

Advancing towards modernization and urbanization, China is currently witnessing a soaring increase in intimate partner homicide (IPH). The present study sought to explore the characteristics of IPHs in China. Data from 979 judgments of this lethal serious crime were analyzed. In comparison with studies from other parts of the world, this study determined the characteristics of IPHs in China in terms of perpetrators, victims, incidents, and types of intimate relationships. Although the previous theoretical research has given reasonable explanations for IPHs, the relationship between perpetrator and victim is actually a neglected area in the study of IPHs. In this study, we found that the relationship between them played a leading role in understanding IPHs in China.

Intimate Partner Homicide Suicide: a Mini-Review of the Literature (2012-2018)

RECENT FINDINGS

In homicide-suicide (HS), a perpetrator kills at least one victim and then commits suicide within a time frame, which is not consistently described in the literature. Most HS happen in an intimate partner relationship (HS-IP), but data about this phenomenon are still scant and poorly systematized.

PURPOSE OF REVIEW

To assess the research papers published about HS-IP from 2012 to 2018 in Pubmed and Scopus. Article selection followed the PRISMA flow diagram. Information was extracted from the selected articles and tabulated. The 22 eligible articles focusing on different types of HS, including HS-IP, suggest that HS-IPs are predominantly committed by men, usually married, cohabiting, or recently separated from their partner, with a medium-low employment status; the victim is usually the current or former female partner. Heterogenity of HS makes it difficult to generalize the results. Implications emerge for the need to target domestic violence and firearm regulation.

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.

Characteristics of Homicide-Suicide in Australia: A Comparison With Homicide-Only and Suicide-Only Cases

Homicide-suicide represents one of the rarest forms of lethal violence but often precipitates calls to revise social, health, and justice policies. However, there is little empirical information about this type of violence. The current study uses two unique data sets to examine a wide range of individual and situational characteristics of homicide-suicide, with particular emphasis on establishing whether and how homicide-suicide differs from homicide-only and suicide-only. Findings suggest homicide-suicide may have unique characteristics that set it apart from both homicide-only and suicide-only, as well as sharing certain other characteristics with those two types of events.

Circumstances Preceding Homicide-Suicides Involving Child Victims: A Qualitative Analysis

Homicide-suicide incidents involving child victims can have a detrimental impact on survivors of the violence, family members and friends of the decedents, and other community members, but the rare occurrence of these acts makes using quantitative data to examine their associated antecedents challenging. Therefore, using qualitative data from the 2003-2011 National Violent Death Reporting System, we examined 175 cases of homicide-suicide involving child victims in an effort to better understand the complex situational factors of these events. Our findings indicate that 98% of homicide-suicides with child victims are perpetrated by adults (mostly parents) and propelled by the perpetrators' intimate partner problems, mental health problems, and criminal/legal problems. These events are often premeditated, and plans for the violence are sometimes disclosed prior to its occurrence. Findings provide support for several theoretical perspectives, and implications for prevention are discussed.

Homicide-Suicide in Cuyahoga County, Ohio, 1991-2016

Research on homicides followed by suicides has relied heavily on small samples and relatively short time spans of data. This study helps to fill this gap by examining 26 years of homicide-suicide data from Cuyahoga County, Ohio, between 1991 and 2016. The main data source for the study is medical examiner files. Analyses of the data indicate the rate of homicide-suicide in Cuyahoga County is consistent with other studies but fluctuates considerably across years studied. The majority of victims are female while perpetrators are overwhelmingly male. Black people are overrepresented as victims and offenders. Use of drugs and/or alcohol leading up to the incident is common among perpetrators. Both the homicides and suicides were overwhelming committed with firearms. When comparing our results to the typology of murder-suicides developed by Marzuk, Tardiff, and Hirsch (JAMA 1992;267:3179), we find amorous jealousy is a significant motivating factor in a many cases, including those involving nonintimate partners. Our findings underscore the importance of widespread use of lethality assessment instruments.

Comparing Homicide-Suicides in the United States and Sweden

Research on homicides followed by suicides has largely relied on very localized samples and relatively short time spans of data. As a result, little is known about the extent to which patterns within cases of homicide-suicides are geographically specific. The current study seeks to help fill this gap by comparing twenty years of homicide-suicide data for Sweden and a large U.S. county. Although some of the underlying patterns in the two countries are similar (e.g., decreasing rates), a number of important differences emerge, particularly with respect to incidence, weapons used, perpetrator age, and relationship of the perpetrator to the victim.

Homicide-suicide in Ghana: perpetrators, victims, and incidence characteristics

Homicide-suicide in the industrialized West has been studied for many years. Yet, only limited scholarly research currently exists on the subject in Africa and other non-Western societies. The aim of the present descriptive study was to investigate homicide-suicides in contemporary Ghana. A content analysis of homicide-suicide reports in a major Ghanaian daily newspaper during 1990 to 2009 was conducted. The results overwhelmingly support findings in the literature, suggesting that homicide-suicides are extremely rare events in Ghana. The overwhelming majority of reported homicide-suicides were committed by males, with females substantially more likely to be the homicide victims. The offenders and victims were generally of low socioeconomic status. Most homicide-suicides involved victims and offenders who were intimately acquainted as family members. The majority of cases involved men who killed their wives on suspicion of infidelity; the next largest category involved men who murdered wives who threatened divorce or separation. The principal homicide and suicide methods were shooting with firearms, hacking with machetes, and stabbing with knives. The findings of the study are discussed in relation to Ghana's patriarchal family system and ideology and present socioeconomic issues in the country. This study recommends further research on this subject in Ghana and other African countries. This is necessary to further an understanding of homicide-suicide as a phenomenon, as well as a necessary prelude to the development and implementation of effective preventive programs.

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

Background

Homicide–suicides are rare but catastrophic events. This study examined the epidemiology of homicide-suicide in Switzerland.

Methods

The study identified homicide–suicide events 1991–2008 in persons from the same household in the Swiss National Cohort, which links census and mortality records. The analysis examined the association of the risk of dying in a homicide–suicide event with socio-demographic variables, measured at the individual-level, household composition variables and area-level variables. Proportional hazards regression models were calculated for male perpetrators and female victims. Results are presented as age-adjusted hazard ratios (HR) with 95% confidence intervals (95%CI).

Results

The study identified 158 deaths from homicide–suicide events, including 85 murder victims (62 women, 4 men, 19 children and adolescents) and 68 male and 5 female perpetrators. The incidence was 3 events per million households and year. Firearms were the most prominent method for both homicides and suicides. The risk of perpetrating homicide-suicide was higher in divorced than in married men (HR 3.64; 95%CI 1.56–8.49), in foreigners without permanent residency compared to Swiss citizens (HR 3.95; 1.52–10.2), higher in men without religious affiliations than in Catholics (HR 2.23; 1.14–4.36) and higher in crowded households (HR 4.85; 1.72–13.6 comparing ≥2 with <1 persons/room). There was no association with education, occupation or nationality, the number of children, the language region or degree of urbanicity. Associations were similar for female victims.

Conclusions

This national longitudinal study shows that living conditions associated with psychological stress and lower levels of social support are associated with homicide-suicide events in Switzerland.

Mortality and causes of death among violent offenders and victims--a Swedish population based longitudinal study

BACKGROUND

Most previous studies on mortality in violent offenders or victims are based on prison or hospital samples, while this study analyzed overall and cause specific mortality among violent offenders, victims, and individuals who were both offenders and victims in a general sample of 48,834 18-20 year-old men conscripted for military service in 1969/70 in Sweden.

METHODS

Each person completed two non-anonymous questionnaires concerning family, psychological, and behavioral factors. The cohort was followed for 35 years through official registers regarding violent offenses, victimization, and mortality. The impact of violence, victimization, early risk factors and hospitalization for psychiatric diagnosis or alcohol and drug misuse during follow up on mortality was investigated using Cox proportional hazard regression analyses.

RESULTS

Repeat violent offenses were associated with an eleven fold higher hazard of dying from a substance-related cause and nearly fourfold higher hazard of dying from suicide. These figures remained significantly elevated also in multivariate analyses, with a 3.03 and 2.39 hazard ratio (HR), respectively. Participants with experience of violence and inpatient care for substance abuse or psychiatric disorder had about a two to threefold higher risk of dying compared to participants with no substance use or psychiatric disorder.

CONCLUSIONS

Violent offending and being victimized are associated with excess mortality and a risk of dying from an alcohol or drug-related cause or suicide. Consequently, prevention of violent behavior might have an effect on overall mortality and suicide rates. Prevention of alcohol and drug use is also warranted.