Flynn Sandra, Gask Linda, Appleby Louis, Shaw Jenny
The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Centre for Mental Health and Safety, Institute of Brain Behaviour and Mental Health, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
Institute of Population Health, University of Manchester, Williamson Building, Oxford Road, Manchester, M13 9PL, UK.
Soc Psychiatry Psychiatr Epidemiol. 2016 Jun;51(6):877-84. doi: 10.1007/s00127-016-1209-4. Epub 2016 Apr 16.
There is a lack of robust empirical research examining mental disorder and homicide-suicide. Primary care medical records are seldom used in homicide-suicide research. The aims of this study were to describe the characteristics of offenders and victims; determine the prevalence of mental disorder and contact with mental health services and examine adverse events prior to the offence.
This was a mixed-methods study based on a consecutive case series of offences in England and Wales occurring between 2006 and 2008. 60 homicide-suicides were recorded. Data sources included coroner's records, police files, General Practice (GP) and specialist mental health records, and newspaper articles.
The results show that most victims were spouse/partners and/or children. Most perpetrators were male (88 %) and most victims were female (77 %). The incidents were commonly preceded by relationship breakdown and separation. 62 % had mental health problems. A quarter visited a GP for emotional distress within a month of the incident. Few had been in recent contact with mental health services before the incident (12 %). Self-harm (26 %) and domestic violence (39 %) were common.
In conclusion, GPs cannot be expected to prevent homicide-suicide directly, but they can reduce risk generally, via the treatment of depression and recognising the risks associated with domestic violence.
缺乏对精神障碍与杀人和自杀行为的有力实证研究。初级保健医疗记录很少用于杀人和自杀研究。本研究的目的是描述犯罪者和受害者的特征；确定精神障碍的患病率以及与心理健康服务机构的接触情况，并调查犯罪前的不良事件。
这是一项基于2006年至2008年期间在英格兰和威尔士发生的一系列连续犯罪案件的混合方法研究。记录了60起杀人和自杀事件。数据来源包括验尸官记录、警方档案、全科医生（GP）和专科心理健康记录以及报纸文章。
结果显示，大多数受害者是配偶/伴侣和/或子女。大多数犯罪者为男性（88%），大多数受害者为女性（77%）。这些事件通常之前存在关系破裂和分居情况。62%的人有心理健康问题。四分之一的人在事件发生后一个月内因情绪困扰去看了全科医生。很少有人在事件发生前近期与心理健康服务机构有过接触（12%）。自残（26%）和家庭暴力（39%）很常见。
总之，不能期望全科医生直接预防杀人和自杀行为，但他们可以通过治疗抑郁症和认识到与家庭暴力相关的风险来总体降低风险。
