Marzuk P M, Tardiff K, Hirsch C S
Department of Psychiatry, Cornell University Medical College, New York, NY 10021.
JAMA. 1992 Jun 17;267(23):3179-83.
To review the epidemiology, patterns, and major determinants of murder-suicide and to discuss the clinical and research strategies for identifying the individuals at greatest risk for this type of violence.
Data were obtained from English-language articles based on searches using MEDLINE (from 1966), PsychINFO (from 1967), and EMBASE (from 1974) programs. In addition, relevant articles, books, and monographs identified from the reference list of retrieved articles were reviewed.
Case-control studies, descriptive epidemiologic surveys, and case series were chosen for review.
Because of the limited scope of the pertinent research literature, all data relevant to the incidence, demographics, circumstances, and precipitants of murder-suicide were summarized by the authors.
Murder-suicide occurs with an annual incidence of 0.2 to 0.3 per 100,000 person-years and accounts for approximately 1000 to 1500 deaths yearly in the United States. The annual incidence of these events is relatively constant across industrialized nations and has not significantly changed over several decades. The principal perpetrators are young males with intense sexual jealousy, depressed mothers, or despairing elderly men with ailing spouses. The principal victims are female sexual partners or consanguineous relatives, usually young children. Clinical depression, specific motivations such as male sexual proprietariness or maternal salvation fantasies, and a history of previous suicide attempts are important in explaining underlying psychopathological mechanisms.
Murder-suicide occupies a distinct epidemiological domain that overlaps with suicide, domestic homicide, and mass murder. These events may be categorized into one of only several phenomenologic typologies that share similar demographics, motivations, and circumstances. Despite the disruption of families and communities caused by murder-suicide, there are no standardized operational definitions, validated taxonomic systems, or national surveillance networks for these events, all of which are needed to develop prevention strategies.
回顾谋杀自杀的流行病学、模式及主要决定因素，并讨论识别此类暴力行为高危个体的临床及研究策略。
数据来自基于使用MEDLINE（自1966年起）、PsychINFO（自1967年起）和EMBASE（自1974年起）程序进行检索的英文文章。此外，还对从检索到的文章参考文献列表中识别出的相关文章、书籍和专著进行了回顾。
选择病例对照研究、描述性流行病学调查和病例系列进行回顾。
由于相关研究文献范围有限，作者总结了所有与谋杀自杀发生率、人口统计学、情况及诱发因素相关的数据。
谋杀自杀的年发生率为每10万人年0.2至0.3起，在美国每年约导致1000至1500人死亡。这些事件的年发生率在工业化国家相对稳定，且几十年来没有显著变化。主要实施者是有强烈性嫉妒的年轻男性、抑郁的母亲或配偶患病而绝望的老年男性。主要受害者是女性性伴侣或血缘亲属，通常是幼儿。临床抑郁症、诸如男性性独占欲或母亲拯救幻想等特定动机以及既往自杀未遂史在解释潜在心理病理机制方面很重要。
谋杀自杀占据一个与自杀、家庭内杀人及大规模谋杀重叠的独特流行病学领域。这些事件可归类为仅有的几种现象学类型之一，它们具有相似的人口统计学、动机和情况。尽管谋杀自杀会给家庭和社区带来破坏，但针对这些事件没有标准化的操作定义、经过验证的分类系统或国家监测网络，而这些对于制定预防策略都是必需的。
