National study comparing the characteristics of patients diagnosed with schizophrenia who committed homicide vs. those who died by suicide

Abstract

Associations between serious mental disorder and violence are well-documented, but there is little epidemiological evidence linking these disorders and homicide risk. The reported study compares socio-demographic and clinical characteristics of people diagnosed with schizophrenia who committed homicide vs. those who died by suicide. The study is a national case series of male patients in England & Wales diagnosed with schizophrenia and convicted of homicide during 1997–2012 (n = 168), and a randomly selected comparison group of male patients with schizophrenia who died by suicide and who were matched to the homicide case series by age (n = 777). There are different patterns of behaviour in people with schizophrenia preceding homicide and suicide. Homicide perpetrators have frequently disengaged with services whilst patients who die by suicide are often in recent contact. This is important knowledge for clinical services as it indicates a different preventive emphasis despite the existence of other shared characteristics.

Keywords:

• Homicide
• suicide
• schizophrenia
• substance misuse
• risk assessment

Acknowledgement

The study was carried out as part of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness at the Centre for Mental Health & Safety. We thank the other members of the research team: Matthew Carr, David While, Pauline Turnbull, Sandra Flynn, Saied Ibrahim, Cathryn Rodway, Su-gwan Tham, Myrsini Gianatsi, Jessica Raphael, Rebecca Lowe, James Burns, Julie Hall, Phil Stones, Rebecca Sherlock, Jane Graney and Huma Daud. We also thank NHS Trust administrative staff for their help and consultant psychiatrists for completing the questionnaires.