Incidence and risk factors of homicide-suicide in Swiss households: National Cohort study.

<h4>Background</h4>Homicide-suicides are rare but catastrophic events. This study examined the epidemiology of homicide-suicide in Switzerland.<h4>Methods</h4>The study identified homicide-suicide events 1991-2008 in persons from the same household in the Swiss National Cohor...

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Main Authors: Radoslaw Panczak, Marcel Zwahlen, Adrian Spoerri, Kali Tal, Martin Killias, Matthias Egger, Swiss National Cohort
Format: article
Language:EN
Published: Public Library of Science (PLoS) 2013
Subjects:
R
Q
Online Access:https://doaj.org/article/b54ed1d99e47436eb1e17a045457e8a1
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Summary:<h4>Background</h4>Homicide-suicides are rare but catastrophic events. This study examined the epidemiology of homicide-suicide in Switzerland.<h4>Methods</h4>The study identified homicide-suicide events 1991-2008 in persons from the same household in the Swiss National Cohort, which links census and mortality records. The analysis examined the association of the risk of dying in a homicide-suicide event with socio-demographic variables, measured at the individual-level, household composition variables and area-level variables. Proportional hazards regression models were calculated for male perpetrators and female victims. Results are presented as age-adjusted hazard ratios (HR) with 95% confidence intervals (95%CI).<h4>Results</h4>The study identified 158 deaths from homicide-suicide events, including 85 murder victims (62 women, 4 men, 19 children and adolescents) and 68 male and 5 female perpetrators. The incidence was 3 events per million households and year. Firearms were the most prominent method for both homicides and suicides. The risk of perpetrating homicide-suicide was higher in divorced than in married men (HR 3.64; 95%CI 1.56-8.49), in foreigners without permanent residency compared to Swiss citizens (HR 3.95; 1.52-10.2), higher in men without religious affiliations than in Catholics (HR 2.23; 1.14-4.36) and higher in crowded households (HR 4.85; 1.72-13.6 comparing ≥2 with <1 persons/room). There was no association with education, occupation or nationality, the number of children, the language region or degree of urbanicity. Associations were similar for female victims.<h4>Conclusions</h4>This national longitudinal study shows that living conditions associated with psychological stress and lower levels of social support are associated with homicide-suicide events in Switzerland.