title: Homicide-suicides compared to homicides and suicides: systematic review and meta-analysis.
abstract: Homicide-suicides, the murder of one or several individuals followed by the suicide of the perpetrator, are rare but have devastating effects on families and communities. We did a systematic review and meta-analysis of studies comparing perpetrators of homicide-suicides with perpetrators of simple homicides and suicides and examined the proportion of firearm use and its correlation with firearm availability. We searched Medline and Embase from inception to July 2012 and identified 27 eligible studies. Perpetrators of homicide-suicides were older and more likely to be male and married to or separated from their victims than perpetrator of simple homicides or suicides. Influence of alcohol and a history of domestic violence or unemployment were less prevalent in homicide-suicides than in homicides. The proportion of firearm use in homicide-suicides varied across countries and was highest in the USA, Switzerland and South Africa, followed by Australia, Canada, The Netherlands and England and Wales, with a strong correlation between the use of firearms and the level of civilian gun ownership in the country. Our results indicate that homicide-suicides represent a distinct entity, with characteristics distinguishing them both from homicides and suicides.
authors: Institute of Social and Preventive Medicine, University of Bern, Switzerland. Electronic address: rpanczak@ispm.unibe.ch.
authors: Radoslaw
authors: R
authors: Panczak
authors: Michael
authors: M
authors: Geissbühler
authors: Marcel
authors: M
authors: Zwahlen
authors: Martin
authors: M
authors: Killias
authors: Kali
authors: K
authors: Tal
authors: Matthias
authors: M
authors: Egger
mesh_terms: D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects; D019548:Crime Victims / Q000706:statistics & numerical data; D017579:Domestic Violence / Q000706:statistics & numerical data; D005260:Female; D006708:Homicide / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data*; D014478:Unemployment / Q000706:statistics & numerical data; D014948:Wounds, Gunshot / Q000401:mortality
keywords: Firearms; Homicide; Homicide–suicide; Meta-analysis; Murder–suicide; Suicide; Systematic review