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Research ArticleRegular Article

Mental Illness in Homicide-Suicide: A Review

Paolo Roma, Floriana Pazzelli, Maurizio Pompili, David Lester, Paolo Girardi and Stefano Ferracuti
Journal of the American Academy of Psychiatry and the Law Online December 2012, 40 (4) 462-468;
Paolo Roma
Dr. Roma is Adjunct Professor, Dr. Pompili is a researcher, Paolo Girardi is Professor, and Dr. Ferracuti is Associate Professor, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy. Dr. Pazzelli is a private practitioner, Rome, Italy. Dr. Lester is Professor of Psychology, The Richard Stockton College of New Jersey, Pomona, NJ.
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Floriana Pazzelli
Dr. Roma is Adjunct Professor, Dr. Pompili is a researcher, Paolo Girardi is Professor, and Dr. Ferracuti is Associate Professor, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy. Dr. Pazzelli is a private practitioner, Rome, Italy. Dr. Lester is Professor of Psychology, The Richard Stockton College of New Jersey, Pomona, NJ.
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Maurizio Pompili
Dr. Roma is Adjunct Professor, Dr. Pompili is a researcher, Paolo Girardi is Professor, and Dr. Ferracuti is Associate Professor, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy. Dr. Pazzelli is a private practitioner, Rome, Italy. Dr. Lester is Professor of Psychology, The Richard Stockton College of New Jersey, Pomona, NJ.
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David Lester
Dr. Roma is Adjunct Professor, Dr. Pompili is a researcher, Paolo Girardi is Professor, and Dr. Ferracuti is Associate Professor, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy. Dr. Pazzelli is a private practitioner, Rome, Italy. Dr. Lester is Professor of Psychology, The Richard Stockton College of New Jersey, Pomona, NJ.
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Paolo Girardi
Dr. Roma is Adjunct Professor, Dr. Pompili is a researcher, Paolo Girardi is Professor, and Dr. Ferracuti is Associate Professor, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy. Dr. Pazzelli is a private practitioner, Rome, Italy. Dr. Lester is Professor of Psychology, The Richard Stockton College of New Jersey, Pomona, NJ.
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Stefano Ferracuti
Dr. Roma is Adjunct Professor, Dr. Pompili is a researcher, Paolo Girardi is Professor, and Dr. Ferracuti is Associate Professor, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy. Dr. Pazzelli is a private practitioner, Rome, Italy. Dr. Lester is Professor of Psychology, The Richard Stockton College of New Jersey, Pomona, NJ.
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    Table 1

    Mental Illness in Homicide-Suicide

    AuthorsPeriodNation/Cityn casesNotesData SourcesKind of Mental Illness (MI)% MI% of MI in Treatment Before the H-S
    Virkunnen311955–1970Finland126Central Statistical Office, hospital recordsSchizophrenia, paranoid psychosis, psychotic depression10
    2
    3
    Gudjonsson and Petursson321900–1979Iceland4Police records, interviews with police, medical reportsPsychotic illness75
    Allen281970–1979Los Angeles104Police filesDepression18
    Rosenbaum271978–1987Albuquerque, New Mexico12Couples only (70.6% of the total of 17 H-S cases)Police files, interviews with family and friends, hospital recordsDepressive disorders (major depression, bipolar, dysthymia)7533
    Milroy141975–1992Yorkshire and the Humber. UK52Coroners' recordsMental health issues21
    Buteau et al.331988–1990Quebec39Coronial servicesAny mental disorder (substance abuse included), depression67
    46
    31
    Milroy et al.291985–1989Victoria, Australia39Coronial servicesDepression, erotomania, morbid jealousy (Othello syndrome)18
    Cohen et al.221988–1994Florida (west central and southeastern)48Twenty-seven cases of spousal H-S in old couples in west central Florida and 21 in Southeastern FloridaComplete medical examiner files and newspaper reportsDepression, other mental illnesses, alcohol/drug abuse29
    6
    6
    Morton et al.201988–1992North Carolina99Only cases involving female victims (>15 years old) and perpetrated by an intimate partnerDatabase of the Office of the Chief Medical Examiner (OCME)Evidence of mental illness, substance abuse15
    18
    Lecomte and Fornes151991–1996Paris and suburbs56Police and judicial filesSevere depression, evidence of psychosis, chronic alcoholism75
    9
    29
    Malphurs and Cohen341997–1999United States673Newspaper surveillanceHistory of psychiatric illness3.8
    Bourget and Gagné351991-May 1998Quebec11Only cases of maternal filicide-suicideCoroners' filesDepression, psychosis82
    9
    Campanelli and Gilson361995–2000New Hampshire16Office of Chief Medical ExaminerDepression, chronic alcoholism, schizophrenia38
    25
    6
    Chan et al.91989–1998Hong Kong56Coroner's CourtDepression, schizophrenia19.6
    7.1
    Hatters Friedman et al.371958–2002Cleveland30Only filicide- suicidesCoroners' filesDepression, psychosis, previous suicide attempt57
    27
    10
    Malphurs and Cohen51998–1999Florida20Only spousal/consortial H-S involving perpetrators aged 55 years old and olderMedical examiner files and law enforcement investigative reportsDepressed mood, suicidal ideation, suicide threat65
    20
    15
    Koziol-McLain et al.381994–2000United States (11 cities)67Only selected femicide-suicide casesPolice and medical examiner recordsAlcohol problem, substance abuse, suicide threats52
    50
    51
    Bossarte et al.42003–2004Several of the United States209National Violent Death Reporting System (NVDRS)Current mental illness, history of mental illness, current depression, alcohol/drug abuse, previous suicide attempts11
    7.2
    8.6
    9.1
    2.6
    Moskowitz et al.391991–2000New Zealand33Police files and coroners' reportsMood disorder, schizophrenia or nonaffective psychosis anorexia nervosa27.3
    12.1
    3
    24.2
    Léveillée et al.401986-March 1994Quebec38Exclusively filicide-suicidesOffice of the Chief Coroner of QuebecDepressive disorders, substance abuse32
    5
    Saleva et al.2April 1987-March 1988Finland10Interviews with family, official policy, medical recordsMajor depression, possible depressive disorder, alcohol/drug abuse40
    30
    20
    Gupta and Gambhir Singh412000–2004Jamnagar region of Gujarat, India8Police inquest, interviews with family, hospital indoor case papersMental illness12.5
    Barber et al.42*2001–2002United States74Coroner or medical examiner reports, police recordsUse of antidepressants15
    Logan et al.432003–200517 U.S. states408National Violent Death Reporting System (NVDRS)Current depressed mood, current mental health problem, alcohol dependence, other substance abuse problem, history of suicide attempts, suspected intoxication, mental distress resulting in mercy killing12.5
    13.7
    6.1
    5.6
    3.4
    22.3
    4.9
    9.6
    12 (anti-depressants)
    Yip et al.101989–2005Hong Kong99Death reports, investigation reports, autopsy reports, psychological reportsAny mental disorder17.4
    Shiferaw et al.441956–2005Geneva, Switzerland23Coroners' recordsDepression, psychosis30
    17
    Gregory451993–2007Yorkshire and the Humber, UK30Coroners' recordsMental health issues7
    Haines et al.4620 yearsTasmania22Coroners' recordsDepression, psychotic symptoms, alcohol abuse, psychiatric disturbance, psychiatric hospitalization9
    9
    32
    14
    25
    Bourget et al.471992–2007Quebec15Only H-Ss perpetrated by individuals aged 65 or olderCoroners' filesMajor depression, other psychiatric disorder, other psychosis87
    6
    6
    Dogan et al.482000–2007Konya, Turkey10The Konya Branch of the Forensic Medicine CouncilMajor depression, antisocial personality disorder, reactive depression in a pedophile20
    10
    10
    • ↵* We have included this study considering the use of antidepressants as a measure of mental illness, despite the diagnostic category.

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Journal of the American Academy of Psychiatry and the Law Online: 40 (4)
Journal of the American Academy of Psychiatry and the Law Online
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1 Dec 2012
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Mental Illness in Homicide-Suicide: A Review
Paolo Roma, Floriana Pazzelli, Maurizio Pompili, David Lester, Paolo Girardi, Stefano Ferracuti
Journal of the American Academy of Psychiatry and the Law Online Dec 2012, 40 (4) 462-468;

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Mental Illness in Homicide-Suicide: A Review
Paolo Roma, Floriana Pazzelli, Maurizio Pompili, David Lester, Paolo Girardi, Stefano Ferracuti
Journal of the American Academy of Psychiatry and the Law Online Dec 2012, 40 (4) 462-468;
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