title: Killing the mother of one's child: psychiatric risk factors among male perpetrators and offspring health consequences.
abstract: OBJECTIVE
  To study possible psychiatric and criminological risk factors of intimate partner femicide (IPF) as well as the bereaved offspring's psychiatric morbidity and premature death.
  
  
  METHODS
  We conducted a nested case-control study, based on Swedish national registries, including all perpetrators of IPF. We computed risk estimates relative to matched population controls, which were compared to those of non-IPF homicide offenders. Exposed children were matched to population controls and followed longitudinally up to 37 years. Offspring outcomes were psychiatric and substance use disorders (according to ICD) self-harm; violent crime; suicide; and premature, all-cause death.
  
  
  RESULTS
  We identified 261 male IPF perpetrators and 494 bereaved children from 1973 through 2009. Multivariable logistic regression suggested that major mental disorder (adjusted odds ratio [OR] = 5.9; 95% CI, 3.3-10.6) and violent crime convictions (adjusted OR = 4.4; 95% CI, 2.7-7.2) were independent risk factors of IPF, but substance use disorders were not (aOR = 0.4; 95% CI, 0.2-1.0). Children exposed to IPF before age 18 years had elevated risks of major mental disorder (adjusted hazard ratio [HR] = 5.7; 95% Cl, 3.0-10.6), substance use disorders (adjusted HR = 5.8; 95% CI, 2.8-11.9) and self-harm (adjusted HR = 5.7; 95% CI, 3.0-11.1). Offspring 18 years or older at the IPF had an increased risk of completed suicide (adjusted HR = 4.3; 95% CI, 1.3-14.5).
  
  
  CONCLUSIONS
  Previous major mental disorder and violent behavior were strong independent risk factors for IPF. Bereavement caused by IPF had significant associations with the offspring's future life, especially for those below 18 years of age at exposure. Our findings demonstrate the need of direct support to the exposed offspring by health care providers and social services.
authors.affiliation: Karolinska Institutet, Department of Clinical Neuroscience/Stockholm County Council, Centre for Psychiatry Research, St Göran's Hospital, SE-112 81 Stockholm, Sweden henrik.lysell@ki.se.
authors.forename: Henrik
authors.initials: H
authors.lastname: Lysell
authors.forename: Marie
authors.initials: M
authors.lastname: Dahlin
authors.forename: Niklas
authors.initials: N
authors.lastname: Långström
authors.forename: Paul
authors.initials: P
authors.lastname: Lichtenstein
authors.forename: Bo
authors.initials: B
authors.lastname: Runeson
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D002675:Child, Preschool; D057237:Criminals / Q000523:psychology*; D005260:Female; D006708:Homicide / Q000523:psychology*; D006801:Humans; D007223:Infant; D000066511:Intimate Partner Violence / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult