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PLoS Medicine Aug 2009Although expert opinion has asserted that there is an increased risk of violence in individuals with schizophrenia and other psychoses, there is substantial... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Although expert opinion has asserted that there is an increased risk of violence in individuals with schizophrenia and other psychoses, there is substantial heterogeneity between studies reporting risk of violence, and uncertainty over the causes of this heterogeneity. We undertook a systematic review of studies that report on associations between violence and schizophrenia and other psychoses. In addition, we conducted a systematic review of investigations that reported on risk of homicide in individuals with schizophrenia and other psychoses.
METHODS AND FINDINGS
Bibliographic databases and reference lists were searched from 1970 to February 2009 for studies that reported on risks of interpersonal violence and/or violent criminality in individuals with schizophrenia and other psychoses compared with general population samples. These data were meta-analysed and odds ratios (ORs) were pooled using random-effects models. Ten demographic and clinical variables were extracted from each study to test for any observed heterogeneity in the risk estimates. We identified 20 individual studies reporting data from 18,423 individuals with schizophrenia and other psychoses. In men, ORs for the comparison of violence in those with schizophrenia and other psychoses with those without mental disorders varied from 1 to 7 with substantial heterogeneity (I(2) = 86%). In women, ORs ranged from 4 to 29 with substantial heterogeneity (I(2) = 85%). The effect of comorbid substance abuse was marked with the random-effects ORs of 2.1 (95% confidence interval [CI] 1.7-2.7) without comorbidity, and an OR of 8.9 (95% CI 5.4-14.7) with comorbidity (p<0.001 on metaregression). Risk estimates of violence in individuals with substance abuse (but without psychosis) were similar to those in individuals with psychosis with substance abuse comorbidity, and higher than all studies with psychosis irrespective of comorbidity. Choice of outcome measure, whether the sample was diagnosed with schizophrenia or with nonschizophrenic psychoses, study location, or study period were not significantly associated with risk estimates on subgroup or metaregression analysis. Further research is necessary to establish whether longitudinal designs were associated with lower risk estimates. The risk for homicide was increased in individuals with psychosis (with and without comorbid substance abuse) compared with general population controls (random-effects OR = 19.5, 95% CI 14.7-25.8).
CONCLUSIONS
Schizophrenia and other psychoses are associated with violence and violent offending, particularly homicide. However, most of the excess risk appears to be mediated by substance abuse comorbidity. The risk in these patients with comorbidity is similar to that for substance abuse without psychosis. Public health strategies for violence reduction could consider focusing on the primary and secondary prevention of substance abuse. Please see later in the article for Editors' Summary.
Topics: Female; Homicide; Humans; Male; Risk Factors; Schizophrenia; Schizophrenic Psychology; Sex Factors; Substance-Related Disorders; Violence
PubMed: 19668362
DOI: 10.1371/journal.pmed.1000120 -
Obstetrics and Gynecology Feb 2022To estimate the prevalence of pregnancy-associated deaths due to drugs, suicide, and homicide nationwide from 2010 to 2019.
OBJECTIVE
To estimate the prevalence of pregnancy-associated deaths due to drugs, suicide, and homicide nationwide from 2010 to 2019.
METHODS
Using U.S. death certificate records from 2010 to 2019 for 33 states plus the District of Columbia, we identified pregnancy-associated deaths using the pregnancy checkbox and International Classification of Diseases, Tenth Revision codes, calculated pregnancy-associated death ratios, and categorized deaths by cause, timing relative to pregnancy, race or ethnicity, and age.
RESULTS
Of 11,782 pregnancy-associated deaths identified between 2010 and 2019, 11.4% were due to drugs, 5.4% were due to suicide, and 5.4% were due to homicide, whereas 59.3% were due to obstetric causes and the remaining 18.5% were due to other causes. Drug-related deaths, suicide, and homicide accounted for 22.2% of pregnancy-associated deaths. All three causes of death increased over the study period, with drug-related pregnancy-associated deaths increasing 190%. Homicide during pregnancy and drug-related deaths, suicides, and homicide in the late postpartum period (43-365 days) accounted for a larger proportion of all deaths in these time periods than the contribution of these causes to all deaths among females of reproductive age. Pregnant and postpartum people identified as non-Hispanic American Indian or Alaska Native were at highest risk of drug-related and suicide death, and people identified as non-Hispanic Black were at highest risk of homicide.
CONCLUSION
Deaths due to drug use, suicide, and homicide constitute more than one fifth of all deaths during pregnancy and the first year postpartum. Drug-related deaths and homicides have increased over the past decade. Substantial racial and ethnic inequities in these deaths exist.
Topics: Adolescent; Adult; Case-Control Studies; Female; Homicide; Humans; Pregnancy; Pregnancy Complications; Substance-Related Disorders; Suicide; United States; Young Adult
PubMed: 34991132
DOI: 10.1097/AOG.0000000000004649 -
Dementia and Geriatric Cognitive... 2022Homicide by older offenders is rare and devastating. It likely occurs due to a complex interaction of personal, social, and environmental factors. Dementia is a...
BACKGROUND
Homicide by older offenders is rare and devastating. It likely occurs due to a complex interaction of personal, social, and environmental factors. Dementia is a progressive neurological condition which may amplify behavioural disturbances such as aggression. This systematic review aims to evaluate the factors associated with homicide committed by people with dementia in order to inform clinical practice.
SUMMARY
MEDLINE, PsychINFO, Embase, and PubMed databases were searched in accordance with PRISMA guidelines for empirical studies examining the characteristics and circumstances of people with dementia who committed homicides. Data on factors associated with the homicide were extracted and the quality of each study rated using standardized criteria. A total of 499 papers were screened and thirteen studies met the inclusion criteria. Study design included case reports (seven studies), case series (four studies), and two retrospective cohort studies, indicative of low levels of evidence. Sample sizes were 1-70. Study findings were predominantly descriptive. Quality ratings ranged from 50 to 100%. Factors associated with disinhibition such as dysexecutive syndrome, alcohol use, and delirium may predispose to severe impulsive aggression. Psychosis and personality pathology appeared to influence targeted assaults resulting in homicide by people with dementia. Victim vulnerability was also a key element.
KEY MESSAGES
The current evidence examining risk factors for homicide committed by people with dementia is limited. However, there are common characteristics reported in these descriptive studies including psychiatric factors and cognitive states causing disinhibition. Recommendations for clinical practice include early assessment of older people with dementia and changed behaviours to allow management of comorbidities and reversible risk factors, alongside education, and advice to carers (who may be targets of aggression). Specialized geriatric forensic psychiatry services and care settings should be developed.
Topics: Aged; Dementia; Homicide; Humans; Psychotic Disorders; Retrospective Studies; Risk Factors
PubMed: 35306488
DOI: 10.1159/000521878 -
Medicine, Health Care, and Philosophy Dec 2022Kant formulated a secular argument against suicide's permissibility based on what he regarded as the intrinsic value of humanity. In this paper, I first show that Kant's...
Kant formulated a secular argument against suicide's permissibility based on what he regarded as the intrinsic value of humanity. In this paper, I first show that Kant's moral framework entails that some types of suicide are morally permissible. Just as some homicides are morally permissible, according to Kant, so are suicides that are performed according to equivalent maxims. Intention, foreseeability, voluntariness, diminished responsibility, and mental capacity determine the moral characterization of the killing. I argue that a suicide taxonomy that differentiates types of suicide according to morally relevant criteria is compatible with Kantian ethics; it establishes that even where we hold a robust deontological sanctity of life position, we are not obligated to preserve the lives of people whose future life only offers profound suffering, and helping them to die may be justifiable if doing so honors their dignity and autonomy. Nevertheless, homicide and suicide are only weakly morally symmetrical in that even if a given suicide is morally impermissible, we do not normally have the right to prevent it forcibly, though this may be altered by juridical laws under some circumstances.
Topics: Humans; Homicide; Suicide; Morals; Dissent and Disputes; Ethics
PubMed: 36006595
DOI: 10.1007/s11019-022-10105-z -
BMC Psychiatry Feb 2014The aim of this study was to estimate the proportion of homicide recidivists among population studies of homicide offenders with schizophrenia. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The aim of this study was to estimate the proportion of homicide recidivists among population studies of homicide offenders with schizophrenia.
METHODS
Systematic review and meta-analysis of published studies of homicide associated with schizophrenia conducted in defined populations and indexed in Medline, PsychINFO, or Embase between January 1960 and November 2013. Published data was supplemented with unpublished data about recidivism obtained by personal communication from the authors of published studies of homicide and schizophrenia. Random effects meta-analysis was used to calculate a pooled estimate of the proportion of homicide recidivists.
RESULTS
Three studies reported that 4.3%, 4.5%, and 10.7% of homicide offenders with schizophrenia had committed an earlier homicide. Unpublished data were obtained from the authors of 11 studies of homicide in schizophrenia published in English between 1980 and 2013. The authors of 2 studies reported a single case of homicide recidivism and the authors of 9 studies reported no cases. The rates of homicide recidivism between studies were highly heterogeneous (I-square = 79). The pooled estimate of the proportion of homicide offenders with schizophrenia who had committed an earlier homicide was 2.3% (95% CI (Confidence Interval) 0.07% to 7.2%), a figure that was not reported in any individual study. The pooled proportion of homicide recidivists from published reports was more than ten times greater (8.6%, 95% CI 5.7%-12.9%) than the pooled proportion of homicide recidivists estimated from data provided by personal communication (0.06%, 95% CI 0.02% to 1.8%).
CONCLUSIONS
In most jurisdictions, homicide recidivism by people with schizophrenia is less common than published reports have suggested. The reasons for the variation in the rates of homicide recidivism between studies are unclear, although in most jurisdictions long-term secure treatment and supervision after release appears to be effective in preventing homicide recidivism. A prospective study conducted in a large population or in multiple jurisdictions over a long period of time might result in a more accurate estimate the risk of a second homicide by a person with schizophrenia.
Topics: Criminals; Female; Homicide; Humans; Male; Middle Aged; Recurrence; Schizophrenic Psychology; Violence
PubMed: 24548381
DOI: 10.1186/1471-244X-14-46 -
BMJ (Clinical Research Ed.) Jan 1996
Topics: Female; Homicide; Humans; Male; Sex Factors; Stereotyped Behavior
PubMed: 8555851
DOI: 10.1136/bmj.312.7022.2 -
International Journal of Environmental... Jul 2022Suicides and homicides are public health problems around the world. The rates of suicide and homicide have increased in the past years. The objectives of this study are...
Suicides and homicides are public health problems around the world. The rates of suicide and homicide have increased in the past years. The objectives of this study are to estimate the rates of suicide and homicide in Mexico City, and to determine the rates of suicide and homicide by sex in the different municipalities of Mexico City during 2019. Data analyzed were obtained from files of governmental organizations in Mexico City. From the general victims-in-research-folders, we choose "victims of crime" or "loss of life by suicide" that happened in 2019. Sex and municipality of residence were obtained. The rate of suicide was of 5.65 cases per 100,000 habitants. Stratified by gender and by municipalities, the highest rates observed were 6.8 suicides per 100,000 males and 29.6 suicides per 100,000 females. The sex ratio was 4.2:1 (males: females). Regarding homicides, the rates were 16.68 homicides per 100,000 females and 67.41 homicides per 100,000 males. The Venustiano Carranza Municipality showed the highest homicide rate in men with 131.72 homicides per 100,000 males. The homicide sex ratio was 7.8:1. The findings of the present study highlight that death by suicide is more common in men with 7.8 more times than in women. The municipalities with higher deaths by suicide have lower rates of homicides and the municipalities with higher deaths by suicide showed lower rates of suicide in men.
Topics: Cities; Female; Homicide; Humans; Male; Mexico; Sex Factors; Suicide
PubMed: 35886691
DOI: 10.3390/ijerph19148840 -
Health & Social Care in the Community Sep 2022Intimate partner homicides are often situated within the context of domestic abuse, and although less prevalent than domestic abuse, there have been several multi-agency...
Intimate partner homicides are often situated within the context of domestic abuse, and although less prevalent than domestic abuse, there have been several multi-agency approaches to understanding the risk for these fatal crimes. Domestic Homicide Reviews (DHRs) were introduced in 2011 to provide information to help with assessing such risk. This paper aims to analyse DHRs in England and Wales to investigate/determine risk factors for domestic homicide following intimate partner abuse. All publicly available DHRs published between July 2011 and November 2020 where the victim and perpetrator were or had been intimate partners (N = 263) were retrieved from Community Safety Partnership websites in England and Wales. A quantitative design was used to extract data from DHRs, and descriptive and inferential statistics were generated by SPSS 26. Findings identified risk factors relating to domestic abuse, including stalking, separation, and the victim being in a new relationship. Sociodemographic risk factors included higher levels of deprivation, lower income and higher barriers to housing and services. This highlights the role of both individual and sociodemographic factors in domestic homicides, and particularly the need for greater socioeconomic security for victims of domestic abuse. In conclusion, though much of the data is in line with previous research, our analysis highlights the pivotal role of regional poverty, with comfortable socioeconomic conditions offering protection against intimate partner homicides. This research suggests important directions for future research and makes a valuable contribution to a more in-depth understanding of the relationship between domestic abuse and intimate partner homicide.
Topics: Homicide; Humans; Intimate Partner Violence; Risk Factors; Sexual Partners; Wales
PubMed: 35178829
DOI: 10.1111/hsc.13753 -
Frontiers in Public Health 2022Italy has one of the lowest homicide rates in Europe. However, while it is decreasing overall, the proportion of murdered women is increasing. This study aimed to...
INTRODUCTION
Italy has one of the lowest homicide rates in Europe. However, while it is decreasing overall, the proportion of murdered women is increasing. This study aimed to analyze the demographic and socioeconomic characteristics associated with homicide mortality in Italy, focusing specifically on male and female differences.
METHODS
Using a longitudinal design, the Italian 2011 General Census population was followed up to 2018. Deaths from homicide were retrieved by a record linkage with the Causes of Death Register. Age-standardized mortality rates, stratified by sex, citizenship, education, and geographic area of residence were calculated. The association between sociodemographic characteristics and homicide mortality was evaluated using quasi-Poisson regression models.
RESULTS
Between 2012 and 2018, 1,940 homicides were recorded in Italy: 53% were females over age 55, 10% were immigrant females, 34% were males aged 40-54 years, 76% had a medium-low education level, and 57% lived in the South and Islands. Foreign citizenship increased a female's risk of dying from homicide (adjusted rate ratio (RRadj): 1.85; 95% CI: 1.54-2.23), while no differences between Italian and immigrant males were found. An inverse association between education and mortality was observed for both sexes, stronger for males (RRadj: 3.68; 95% CI: 3.10-4.36, low vs. high) than for females (RRadj: 1.38; 95%CI: 1.17-1.62, low vs. high). Moreover, a male residing in the South or the Islands had almost 2.5 times the risk of dying from homicide than a resident in the North-West. Finally, old age (over 75) increased a female's risk of being murdered, whereas the highest risk for males was observed for those aged 25-54 years.
CONCLUSIONS
Male and female differences in homicide mortality profiles by age were expected, but the results by residence, citizenship, and education highlight that living in disadvantaged socioeconomic contexts increases the risk of dying from homicide, suggesting the need to implement specific prevention and intervention strategies.
Topics: Educational Status; Europe; Female; Homicide; Humans; Italy; Longitudinal Studies; Male
PubMed: 35910885
DOI: 10.3389/fpubh.2022.919335 -
JAMA Pediatrics Jun 2019Intimate partner violence during adolescence is widespread, and consequences can be severe. Intimate partner homicide (IPH) is the most extreme form of intimate partner...
IMPORTANCE
Intimate partner violence during adolescence is widespread, and consequences can be severe. Intimate partner homicide (IPH) is the most extreme form of intimate partner violence, but literature on IPH has almost exclusively focused on adults.
OBJECTIVES
To determine the proportion of adolescent homicides that is perpetrated by intimate partners and to describe the victim, perpetrator, and incident characteristics of these IPHs.
DESIGN, SETTING, AND PARTICIPANTS
Analysis of quantitative and qualitative surveillance data from the National Violent Death Reporting System from 2003 to 2016. Data represent 32 states that contributed to the system for 1 year or longer. There were 8048 homicides of victims aged 11 to 24 years with a known relationship between the victim and perpetrator. For persons aged 11 to 18 years, there were 2188 homicides. Analysis began September 2018.
MAIN OUTCOMES AND MEASURES
An incident was identified as an IPH if the relationship between the perpetrator and victim was coded as spouse, ex-spouse, girlfriend or boyfriend, ex-girlfriend or ex-boyfriend, or girlfriend or boyfriend (unspecified current or former). Variables of interest included demographic characteristics (age, sex, race/ethnicity) for the victim and perpetrator, relationship status at time of death, homicide-suicide, homicide method, firearm type, and location of homicide. Contextual categories were created from the qualitative narratives.
RESULTS
Of adolescent homicides, 150 (6.9%) were classified as IPH. A total of 135 victims (90%) were female (mean [SD] age, 16.8 [1.3] years). Overall, 102 perpetrators (77.9%) were 18 years and older (mean [SD] age, 20.6 [5.0] years), and 94 (62.7%) were current intimate partners of the victim. Firearms, specifically handguns, were the most common mechanism of injury. Compared with IPHs of young adults aged 19 to 24 years, perpetrators of adolescent victims were younger and less likely to be a current intimate partner. The most common categories of adolescent IPH homicides were broken/desired relationship or jealousy and an altercation followed by reckless firearm behavior and pregnancy related.
CONCLUSIONS AND RELEVANCE
Adolescents, particularly girls, in dating relationships may face risk of homicide, especially in circumstances of a breakup or jealousy and when perpetrators have access to firearms. Understanding homicide in early dating relationships can inform prevention and intervention efforts tailored to adolescents.
Topics: Adolescent; Adolescent Behavior; Child; Female; Homicide; Humans; Intimate Partner Violence; Male; Risk Factors; United States; Young Adult
PubMed: 30985886
DOI: 10.1001/jamapediatrics.2019.0621