Gunn John C
Institute of Psychiatry, King's College London, London, UK.
Crim Behav Ment Health. 2019 Aug;29(4):239-246. doi: 10.1002/cbm.2125. Epub 2019 Sep 4.
Suicide with accompanying homicide is frightening and ill understood.
To raise professional awareness of its complexities and difficulties and identify areas for developing research.
A Crime in Mind seminar was held in London in December 2018, with four expert presentations and discussion. This paper draws on that seminar and supplementary literature.
Homicide/suicide is very difficult to predict and thus prevent. Victims and perpetrators may have a dependency relationship. Better training, especially of general practitioners, may increase the likelihood of detecting signs of despair and delusional ideas. Psychiatrists should be more alert to fixed delusions and homicidal thoughts. Individual assessment and management alone is unlikely to be sufficient. Public health strategies are likely to be important too. Weapons control is vital. Employers of people with great personal responsibility and special access to potentially lethal tools, such as airline pilots, and perhaps clinicians, should have regular, compulsory, mental health checks.
Six points of clinical importance emerged, including lowering the threshold for diagnosing delusional disorder and the establishment of anti-violence clinics.
伴有杀人行为的自杀令人恐惧且鲜为人知。
提高专业人员对其复杂性和困难的认识，并确定开展研究的领域。
2018年12月在伦敦举办了一场“犯罪心理”研讨会，有四场专家报告及讨论。本文借鉴了该研讨会及补充文献。
杀人/自杀行为很难预测，因此也难以预防。受害者和实施者可能存在依赖关系。更好的培训，尤其是对全科医生的培训，可能会增加发现绝望迹象和妄想观念的可能性。精神科医生应更加警惕固定妄想和杀人念头。仅靠个体评估和管理不太可能足够。公共卫生策略可能也很重要。武器管制至关重要。对承担重大个人责任且能特别接触到潜在致命工具的人员，如航空公司飞行员，或许还有临床医生的雇主，应进行定期、强制的心理健康检查。
出现了六点临床重要性，包括降低妄想障碍的诊断阈值以及设立反暴力诊所。
