Cohen D, Llorente M, Eisdorfer C
Department of Aging and Mental Health, Florida Mental Health Institute, University of South Florida, USA.
Am J Psychiatry. 1998 Mar;155(3):390-6. doi: 10.1176/ajp.155.3.390.
The objective of this study was to determine the annual incidence of homicide-suicide and to compare patterns and antecedents in old and young spousal/consortial cases.
Homicide-suicide cases were ascertained in four medical examiner districts covering seven entire Florida counties from 1988 to 1994. The districts were chosen to determine rates in two regions of Florida, comparable in size of the total population and proportion of older persons. Annual homicide-suicide incidence rates per 100,000 population and homicide-suicides as a percentage of total homicides and total suicides separately were calculated by age group and Florida region. Complete medical examiner files were obtained, and 160 variables were coded from medical examiner reports to compare features and clinical characteristics by age and region.
Annual incidence rates ranged from 0.3 to 0.7 per 100,000 for persons under age 55 and from 0.4 to 0.9 per 100,000 for persons age 55 and older, with higher rates in the older group every year but two. Cases of spousal/consortial homicide-suicide were the most common in both age groups. The younger couples in both regions were comparable, except for racial composition, but the older couples differed. West central Florida couples were in their seventies, Caucasian, usually married, and both in poor health; and there were indications of depression or alcohol abuse in half the perpetrators. Two-thirds of the southeastern Florida couples were Hispanic; there was a mean age difference of 18 years between perpetrators and victims; and verbal discord, physical violence, and separation were prominent antecedents.
The base rate for homicide-suicide in both age groups was higher than that reported in previous studies. Spousal/consortial homicide-suicides were the dominant form, and although psychopathology was strongly implicated, homicide-suicides are violent lethal acts resulting from additive or multiplicative effects of diathesis, including culture, and stressful experiences.
本研究的目的是确定他杀-自杀的年发生率，并比较老年和年轻配偶/伴侣案件的模式及前因。
1988年至1994年期间，在涵盖佛罗里达州七个完整县的四个法医辖区确定了他杀-自杀案件。选择这些辖区是为了确定佛罗里达州两个地区的发生率，这两个地区的总人口规模和老年人比例相当。计算了按年龄组和佛罗里达州地区划分的每10万人的年他杀-自杀发生率，以及他杀-自杀分别占总杀人案和总自杀案的百分比。获取了完整的法医档案，并从法医报告中对160个变量进行编码，以比较不同年龄和地区的特征及临床特点。
55岁以下人群的年发生率为每10万人0.3至0.7例，55岁及以上人群的年发生率为每10万人0.4至0.9例，除两年外，老年组的发生率每年都更高。配偶/伴侣他杀-自杀案件在两个年龄组中最为常见。除种族构成外，两个地区的年轻夫妇情况相似，但老年夫妇有所不同。佛罗里达州中西部的夫妇年龄在70多岁，是白人，通常已婚，两人健康状况都不佳；一半的犯罪者有抑郁或酗酒迹象。佛罗里达州东南部三分之二的夫妇是西班牙裔；犯罪者和受害者之间的平均年龄差为18岁；言语不和、身体暴力和分居是突出的前因。
两个年龄组的他杀-自杀基础发生率均高于先前研究报告的水平。配偶/伴侣他杀-自杀是主要形式，虽然精神病理学有很大关联，但他杀-自杀是由素质（包括文化）和压力经历的相加或相乘效应导致的暴力致死行为。
