背景:杀人后自杀很少见,在世界范围内具有破坏性和破坏性。通常认为肇事者患有精神障碍,提出相关的预防问题。尽管已经报道了事件,以前没有对肇事者的心理健康进行系统审查。
目标:我们的目标是双重的。首先,在已发表的文献中确定是否存在可识别的杀人-自杀亚组,其次,调查行为人精神状态与事件各方面的关系。
方法:我们对已发表的关于24小时内自杀或严重自杀未遂的凶杀研究的文献进行了系统综述,其中包括对犯罪者精神状态的测量。
结果:确定了60项研究,大部分来自北美或欧洲。方法上,研究过于异质性,无法进行荟萃分析。他们分为三个主要群体:家庭,大规模射击,和恐怖分子,还有一个混合的小团体。少数肇事者中有精神疾病的证据;其余的人没有精神疾病,只有部分证据。任何特定的精神疾病和自杀类型之间都没有明确的联系,虽然抑郁症被引用得最多。社会角色的分离,动机,药物滥用和相关风险或威胁行为是所有群体确定的主题.预先确立的意识形态与大规模射击者和恐怖主义团体有关。在恐怖组织中,先前的创伤史很明显。
结论:研究数据必须在事件发生后收集,在大多数情况下没有标准化方法,因此,必须谨慎解释调查结果。然而,他们建议至少对精神卫生专业人员有一些预防作用。那些接受抑郁症服务的人,自杀意念,关系困难和实际,或感知,社会地位或角色的变化值得详述,随着时间的推移,支持性评估。
BACKGROUND: Homicide followed by suicide is rare, devastating and perpetrated worldwide. It is commonly assumed that the perpetrator had a mental disorder, raising concomitant questions about prevention. Though events have been reported, there has been no previous systematic review of the mental health of perpetrators.
OBJECTIVE: Our aims were twofold. First, to identify whether there are recognisable subgroups of homicide-suicides in published literature and, secondly, to investigate the relationship between perpetrator mental state and aspects of the incident.
METHODS: We conducted a systematic review of published literature on studies of homicide followed within 24 h by suicide or serious suicide attempt that included measures of perpetrator mental state.
RESULTS: Sixty studies were identified, most from North America or Europe. Methodologically, studies were too heterogeneous for meta-analysis. They fell into three main groups: family, mass shooter, and terrorist with an additional small mixed group. There was evidence of mental illness in a minority of perpetrators; its absence in the remainder was only partially evidenced. There was no clear association between any specific mental illness and homicide-suicide type, although depression was most cited. Social role disjunction, motive, substance misuse and relevant risk or threat behaviours were themes identified across all groups. Pre-established ideology was relevant in the mass shooter and terrorism groups. Prior trauma history was notable in the terrorist group.
CONCLUSIONS: Research data were necessarily collected post-incident and in most cases without a standardised approach, so findings must be interpreted cautiously. Nevertheless, they suggest at least some preventive role for mental health professionals. Those presenting to services with depression, suicidal ideation, relationship difficulties and actual, or perceived, changes in social position or role would merit detailed, supportive assessment over time.