Abstract
Background: International literature has examined the offence characteristics of homicide in the general population, but there has been limited research investigating diagnostic differences between perpetrators who commit homicide by differing methods. Objective: To investigate the methods of homicide by people with different psychiatric diagnoses and to explore the offence characteristics of perpetrators with schizophrenia, in a seven-year (1997–2003) national sample of homicide perpetrators in England and Wales. Results: Of the 3930 homicide perpetrators identified, over a third (36%) used a sharp instrument. The use of firearms was rare. Methods of homicide differed significantly between diagnostic groups. Perpetrators with schizophrenia were more likely to use a sharp instrument and predominantly killed a family member or spouse in the home; a significant majority were mentally ill at the time of the offence. Perpetrators diagnosed with affective disorder were more likely to use strangulation or suffocation. Alcohol dependent perpetrators used hitting or kicking significantly more often, primarily to kill acquaintances. Finally, drug dependent perpetrators were more likely to use non-violent methods, particularly poisoning. Conclusion: Methods of homicide are affected not only by the social and behavioural characteristics of the perpetrator and victim, but also by the perpetrator's psychiatric history and diagnosis.
Acknowledgements
The study was carried out as part of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, funded by the National Patient Safety Agency. We thank the other members of the research team: Alyson Ashton, Harriet Bickley, Jimmy Burns, Rebecca Lowe, Phil Stones, Pauline Turnbull, David While, and Kelly Hadfield. We acknowledge the help of health authorities and trust contacts, and thank consultant psychiatrists for completing the questionnaires.
Declaration of interest LA is the National Director of Mental Health for England.