An unusual case of homicide-suicide: overkilling by stabbing and suicide by hanging.

Background: This case presents a detailed forensic examination of a unique femicide case followed by the perpetrator's suicide. Case report: On a Sunday afternoon, a 52 year old man killed his 43 year old partner in their home with eleven stab wounds. A few minutes later, he committed suicide by suspending himself to a tree in their home garden by means of a rope. This unique case is interesting because of the combination of methods used for both homicide and suicide, as well as the relationship dynamics between the victim and perpetrator. The perpetrator committed homicide by stabbing and then hanged himself. Conclusion: The case adds valuable knowledge to Forensic Medicine, advocating for increased awareness and preventive measures against domestic and gender-based violence. This report provides an in-depth analysis of a homicide-suicide incident, focusing on a unique case of homicide-suicide. It serves to highlight the global crisis of femicide. The case is situated within the context of gender- based violence, illustrating how such acts are deeply rooted in societal norms. It highlights patterns of intimate partner violence, where emotional factors play a significant role. Forensic analysis uncovered the overkill nature of the homicide, indicating excessive injuries beyond what was necessary for death, reflecting the psychological turmoil of the perpetrator. It emphasizes the importance of identifying signs of potential violence in domestic settings and implementing interventions for mental health support and the prevention of genderbased violence.

A systematic review of literature on homicide followed by suicide and mental state of perpetrators.

BACKGROUND: Homicide followed by suicide is rare, devastating and perpetrated worldwide. It is commonly assumed that the perpetrator had a mental disorder, raising concomitant questions about prevention. Though events have been reported, there has been no previous systematic review of the mental health of perpetrators. AIMS: Our aims were twofold. First, to identify whether there are recognisable subgroups of homicide-suicides in published literature and, secondly, to investigate the relationship between perpetrator mental state and aspects of the incident. METHODS: We conducted a systematic review of published literature on studies of homicide followed within 24 h by suicide or serious suicide attempt that included measures of perpetrator mental state. RESULTS: Sixty studies were identified, most from North America or Europe. Methodologically, studies were too heterogeneous for meta-analysis. They fell into three main groups: family, mass shooter, and terrorist with an additional small mixed group. There was evidence of mental illness in a minority of perpetrators; its absence in the remainder was only partially evidenced. There was no clear association between any specific mental illness and homicide-suicide type, although depression was most cited. Social role disjunction, motive, substance misuse and relevant risk or threat behaviours were themes identified across all groups. Pre-established ideology was relevant in the mass shooter and terrorism groups. Prior trauma history was notable in the terrorist group. CONCLUSION: Research data were necessarily collected post-incident and in most cases without a standardised approach, so findings must be interpreted cautiously. Nevertheless, they suggest at least some preventive role for mental health professionals. Those presenting to services with depression, suicidal ideation, relationship difficulties and actual, or perceived, changes in social position or role would merit detailed, supportive assessment over time.

A Descriptive Study of the Characteristics of Homicide-Suicide in Forensic Autopsy Cases.

Homicide followed by suicide (HS) is a tragic event with varied characteristics across countries and regions. Compared to Western countries, there are limited studies on HS in Asian countries. Therefore, this study aimed to clarify the characteristics of recent HS cases by examining forensic autopsy records from 2008 to 2020 collected from the Department of Legal Medicine, Chiba University, in Japan. A total of 77 HS cases were identified, involving 77 perpetrators (52 completed suicides, 25 attempted suicides), with 28 perpetrator and 89 victim autopsies. Our findings showed that older adults accounted for nearly half of the victims; victims were mostly females, whereas most perpetrators were male. The most common HS relationship was that between a parent and a child. Autopsy findings showed that the most common cause of death was strangulation, and illegal drugs were detected only in a few cases; however, psychotropic drugs were detected in child victims. No obvious evidence of past child physical abuse by caregivers was found. In contrast, intimate partner violence (IPV) was present, with a history of IPV found in half of HS cases involving adult intimate partner relationships. Notably, gender differences in age and relationship to the victim were identified. Likewise, some perpetrators may have expressed their plans and intentions for HS before the event, which may represent an important sign for HS prevention. However, to accurately reveal the course of HS, nationwide integrated statistics, forensic autopsies, including toxicological analyses of the deceased; and forensic psychiatric perspectives, including psychological autopsy, are required.

A classification of combined homicide-suicide: An update-Part I: Introduction and psychopathology.

A 1995 classification of combined homicide-suicide was based on the psychopathology of the perpetrator and the relationship between the perpetrator and the victim(s). A three-part model was proposed for the study and potential understanding of individual homicide-suicide acts. This triarchic model consisted of the concepts of ego weakness, stress, and vector, the vector representing the ideational component. Today, approaching a quarter of a century after this initial classification based on a review of the literature available then, a considerable volume of experience and investigative knowledge has been published advancing our knowledge of homicide-suicide. The present review updates and revises the original classification, retains the two-part, psychopathological and relational classification, and adds several categories. Because this updated classification is more expansive than the original, it is presented in three parts. Part I, the present article, provides the introduction to this classification and the classification of mental conditions that may attend homicide-suicide. Parts II and III will address intrafamilial and extrafamilial homicide-suicide, respectively, the two major divisions of the classification based on the relationship between the actor and the homicide victim(s). All three parts are integral to this classification and belong together.

Adversarial Homicide-Suicide Perpetrated by Domestic Helper: A Case Report From Nepal.

The majority of literature on homicide-suicide addresses the fact that victims are predominantly female, and offenders are typically adult males (older than the victims) who share a familial, marital, or consortial relationship with them. The probability of fatalities involving murder-suicides in the bedrooms of middle-class households is higher. We present a case where an adolescent domestic helper strangled his landlady, twice his age, only to commit suicide by hanging thereafter. We go on to discuss homicide-suicide by servants outside the consortial relationship and the possible reasons for it in the Nepalese context.

Murder-suicides in Milan: case history from 1990 to 2018. Criminological and medico-legal considerations.

This study reviews autopsies performed by the Legal Medicine department of the University of Milan from 1990 to 2018. In particular, the characteristics of the perpetrator, the victim and the type of existing relationship, the means used, and the place and time of the crime. A retrospective analysis was conducted, extracting data from the Milan Institute of Legal Medicine database, selecting cases of murder-suicide from the archive between 1990 and 2018 (a total of 75 cases with 84 murder victims). Available data was processed statistically. Univariate and bivariate analysis techniques were mainly used. Significance tests (Chi-square) and correlation studies (Pearson's R) were also conducted, the results of which were then examined and discussed in light of legal, medical and criminological expertise.In almost all cases, suicide followed immediately after the murder, at home and in the context of an emotional relationship. The murderer and person committing suicide is almost always male and the victim female. A firearm was the most common weapon in cases of both murder and suicide.The results indicate that the issue of gender is relevant in murder-suicides as indicated by international and national literature on homicides. Furthermore, the use of firearms endorses the importance of limiting their availability through more restrictive laws.

Suicide pacts in the Milan district (Italy): A retrospective autopsy-based study with literature review.

Suicide pacts are unique events, which involve two or more individuals. In such cases, the initiator and the addicted victim decide to end their lives together in the same place and at the same time. In the present research, on the 26,054 autopsy reports assessed at the Milan Institute of Legal Medicine from 1993 to 2020, 4596 suicides were collected. Among them, 6 cases of suicide pacts were registered, which involved two couples of friends, two couples of spouses, one couple of lovers and one couple of identical twins. Gunshots and acute poisonings were the most common suicidal methods that were adopted. Suicidal notes were documented in 4 cases, which reported the reasons and the consent of the victims. Suicidal notes clearly allow the correct identification of suicide pacts. Furthermore, they often explain the reasons which are frequently based on either psychiatric disorders or financial problems. In the other cases, the absence of farewell notes could complicate forensic investigations, especially to establish the differential diagnosis with murder-suicides without the explicit consent of the victims. In this setting, multidisciplinary skills are preferably required, including a full forensic autopsy with ancillary postmortem analyses (e.g., toxicology, histopathology, and forensic genetics). Furthermore, this study aims to discuss the suicide pacts from a medicolegal, criminological, and sociological point of view, providing a review of the literature with a comparison of our forensic cases.

Immunohistochemical detection of insulin at the injection site in a case of suspected murder with the suicide of the perpetrator.

In medicolegal practice, rare cases involving suicidal, criminal, or accidental insulin overdose are both analytically and forensically challenging. The aim of this study is to present a model procedure in such cases, developed at the Department of Forensic Medicine and Toxicology of the Medical University of Silesia in Katowice, with particular emphasis on the possibility of additional confirmation of insulin intake by its immunohistochemical detection at the injection site. In the example case presented here, an immunohistochemical examination using FLEX Polyclonal Guinea Pig Anti-Insulin antibody (code IR002, Dako) confirmed the presence of insulin in the subcutaneous tissue of the victims. In our opinion, the method of immunohistochemical detection of insulin at the injection site can and should be used routinely in such cases.

The overview of forensic genetic genealogy.

Forensic genetic genealogy (FGG) benefits largely from popularity of genealogical research within (mostly) American society and the advent of new sequencing techniques that allow typing of challenging forensic samples. It is considered a true breakthrough for both active and especially cold cases where all other resources and methods have failed during investigation. Despite media coverage generally highlighting its powers, the method itself is considered very laborious and the investigation may easily got suspended at every stage due to many factors including no hits in the database or breaks in traceable lineages within the family tree. This review summarizes the scope of FGG use, mentions most concerns and misconceptions associated with the technique and points to the plausible solutions already suggested. It also brings together current guidelines and regulations intended to be followed by law enforcement authorities wishing to utilize genetic genealogy research.

Neuropathological Changes in the Brains of Suicide Killers.

BACKGROUND: Homicide combined with subsequent suicide of the perpetrator is a particular form of interpersonal violence and, at the same time, a manifestation of extreme aggression directed against oneself. Despite the relatively well-described individual acts of homicide and suicide, both in terms of psychopathology and law, acts of homicide and subsequent suicide committed by the same person are not well-studied phenomena. The importance of emotional factors, including the influence of mental state deviations (psychopathology), on this phenomenon, is discussed in the literature, but still there is relatively little data with which to attempt neuropathological assessments of the brains of suicide killers. This paper is dedicated to the issue based on the neuropathological studies performed. METHODS: We analyzed a group of murder-suicides using histochemical and immunohistochemical methods. RESULTS: The results of our research indicate the presence of neurodegenerative changes including multiple deposits of ß-amyloid in the form of senile/amyloid plaques and perivascular diffuse plaques. CONCLUSIONS: Neurodegenerative changes found in the analyzed brains of suicide killers may provide an interesting starting point for a number of analyses. The presence of neurodegenerative changes at such a young age in some murderers may suggest preclinical lesions that affect cognitive functions and are associated with depressed moods.

Submerged corpses of an elderly couple retrieved from a canal with alcohol detected in their blood: A rare case of murder-suicide by drowning?

The body of an elderly man and his disabled wife were found submerged in a canal in open country one afternoon. They had last been seen alive that morning. The man's car was parked close to the canal and the woman's wheelchair was located in a stable position a few meters from the canal bank, facing away from the water. There were abrasions and bruises on the woman's forearms and hands and lower left leg, and the man's body displayed a bruise on the left hand and an abrasion of the left thumb likely caused by a fingernail. Other observations included frothy fluid exuding from the nose and in the airways, overdistended lungs with rib impressions and clear watery fluid in the stomach of both victims. Ethanol was detected in the peripheral blood of both corpses (1.0 g/L in the woman, 0.25 g/L in the man). The man was known to be stressed and depressed: he cared for his ailing spouse, who was affected by severe cognitive impairment and he had on several occasions expressed a desire to put an end to their misery. The hypotheses of a suicide pact or a double accident were in contrast with the woman's mental state and with the position of the wheelchair, respectively. The manner of death was consistent with a spousal murder-suicide involving a double drowning. Papers reporting similar cases are infrequent in the literature.

Suicidal and Aggressive Ideation Associated with Feelings of Embitterment.

BACKGROUND: Mental disorders can be associated with suicidal or aggressive ideation and behavior, especially in the context of embitterment. The aim of this study is to investigate the types, prevalence, and dangerousness of aggressive and suicidal ideations associated with embitterment. METHODS: When therapists from the department of behavioral medicine detected signs of embitterment, aggression, or suicidal thoughts in their patients, they routinely filled out a questionnaire on aggressive ideation, assessed the embitterment, and contacted a senior psychiatrist. Additionally, patients answered an embitterment scale. RESULTS: There were 127 patients (3.84% of all patients) with suicidal and/or aggressive ideation. They had an increased score of 2.93 (SD 0.74) on the embitterment scale, associated with personal vilification (62.7%), breach of trust (30.2%), public humiliation (25.4%), death/loss (5.6%), or attacks by another person (14.3%). We found that 83.5% of the patients harbored aggressive ideations; in 94.1% of this group, these were directed against the person who had caused the problem, 88.3% wanted to inflict severe damage, 38.8% to harm another person, 31.5% showed suicidal ideation, and 3.2% had fantasies of murder-suicide. Only 34.3% of the patients reported spontaneously about their current aggressive ideation. The limitations of the study are that the data come from an inpatient sample and patients were identified according to clinical judgement. CONCLUSION: Aggressive ideation is regularly associated with embitterment. This deserves the attention of therapists for the prevention of aggressive acts.

Circumstances Preceding Homicide-Suicides Involving Child Victims: A Qualitative Analysis.

Homicide-suicide incidents involving child victims can have a detrimental impact on survivors of the violence, family members and friends of the decedents, and other community members, but the rare occurrence of these acts makes using quantitative data to examine their associated antecedents challenging. Therefore, using qualitative data from the 2003-2011 National Violent Death Reporting System, we examined 175 cases of homicide-suicide involving child victims in an effort to better understand the complex situational factors of these events. Our findings indicate that 98% of homicide-suicides with child victims are perpetrated by adults (mostly parents) and propelled by the perpetrators' intimate partner problems, mental health problems, and criminal/legal problems. These events are often premeditated, and plans for the violence are sometimes disclosed prior to its occurrence. Findings provide support for several theoretical perspectives, and implications for prevention are discussed.

Judicial Murder-Suicides in Van Diemen's Land.

On the morning of December 17, 1827, nine convicts were executed by public hanging in Hobart Town, the capital of the British colony of Van Diemen's Land (now the Australian state of Tasmania). Two months previously they had drowned senior Constable George Rex on Small Island, which was part of the penal settlement at Macquarie Harbor, in front of five bound and gagged witnesses. They offered no defence at their trial. Examination of the Tasmanian colonial convict records shows that "suicide by lottery" involved convicts choosing two men, one to die and the other to kill him. The witnesses would earn a respite when taken away for the trial, and the murderer would be executed. "Death by gallows" could be considered a nineteenth-century version of an orchestrated suicide reminiscent of more modern "death by cop." This category of "judicial" murder-suicide expands the range of contemporary classifications of dyadic deaths.

Familial Vehicular Murder-Suicide.

A certain number of single-vehicle crashes into stationary roadside objects such as trees are thought to be occult suicides. However, is it possible that some cases of multiple deaths within a family in similar crashes are due to unrecognized familial murder-suicides? A 39-year-old woman and her 11-year-old daughter are reported who died of injuries following a vehicle impact with a tree. Unusual behavior of the mother leading up to the crash, and assessment at the scene, raised the possibility of this being a nonaccidental event. However, difficulties in retrospectively determining the intent of a driver in a vehicle crash, and the nonrecording of, or lack of separate coding for murder-suicides on registers, make determination of the incidence of these types of events extremely difficult. It may be that this is a subcategory of murder-suicide that is underdiagnosed and so is not being registered on central motor vehicle crash databases.

Military Versus Civilian Murder-Suicide.

Previous studies have implicated significant differences between military members and civilians with regard to violent behavior, including suicide, domestic violence, and harm to others, but none have examined military murder-suicide. This study sought to determine whether there were meaningful differences between military and civilian murder-suicide perpetrators. Using data from the Center for Disease Control's (CDC) National Violent Death Reporting System (NVDRS), military ( n = 259) and civilian ( n = 259) murder-suicide perpetrators were compared on a number of demographic, psychological, and contextual factors using chi-square analyses. Logistic regression was used to determine which variables predicted membership to the military or civilian perpetrator groups. Military murder-suicide perpetrators were more likely to be older, have physical health problems, be currently or formerly married, less likely to abuse substances, and to exhibit significantly different motives than civilian perpetrators. Logistic regression revealed that membership to the military, rather than the civilian, perpetrator group was predicted by age, physical health problems, and declining heath motive-reflecting the significance of a more than 15-year difference in mean age between the two groups. Findings point to the need to tailor suicide risk assessments to include questions specific to murder-suicide, to assess attitudes toward murder-suicide, and to the importance of assessing suicide and violence risk in older adult military populations.

An unusual case of murder-suicide: The importance of studying knots.

An atypical murder-suicide that involved a married couple over 80 years of age was investigated at the Institute of Legal Medicine of the University of Chieti-Pescara and is presented and discussed here. The whole story allows us to confront the difficulties involved in the discovery of a dead body in water when the circumstantial evidence does not allow any unique interpretation of the facts. The atypical and misleading element appeared to be how the body of the man was tied, with the interpretation inclined towards a homicidal manner of death. It was only by combining the contributions of each of the findings that emerged during the course of the autopsy with the circumstantial evidence from the site inspection that it was possible to reach resolution of this case, which was then identified as a murder-suicide.

“Morri para inspirar vocês”: uma análise das narrativas em disputa perpetradas por jovens homicidas/suicidas em ambientes escolares / “I died to inspire you”: an analysis of the narratives in dispute perpetrated by school shooters / “Morí para inspirarte”: un análisis de las narrativas en disputa perpetradas por jóvenes homicidas/suicidas en el ámbito escolar

Este artigo analisa crimes de homicídio/suicídio cometidos por jovens na circunscrição de instituições de ensino. Nosso foco são os perpetradores que buscam o desenvolvimento de produtos comunicacionais, a partir de linguagens diversas, com o intuito de subsidiar o trabalho de apuração da mídia e, assim, disputar com esta, após a sua morte, o direito de significar midiaticamente. Os jovens homicidas/suicidas se convertem em autores dos delitos e dos discursos na medida em que pretendem fazer resistir suas memórias já na condição de indivíduos mortos. Tal estratégia evidencia um paradoxo: em tempos de grandes investimentos em intervenções que visam à prorrogação da vida, os indivíduos infames utilizam a potência indomesticável da morte para forjar um tipo de existência que passa, necessariamente, pela imagem midiatizada do crime e pelo auto aniquilamento biológico. Este fenômeno é analisado a partir dos crimes de Cho Seung-Hui, Pekka-Eric Auvinen e Wellington Menezes de Oliveira.

This paper discusses the crimes of murder/suicide committed by young people within the space ofeducational institutions. Our corpus analysis is restricted to a specific type of perpetrator that seeks the development of communication products, using different styles, in order to support the journalistic work of inquiry about their crimes and, thus be able to intervenes and competes with the media for the right to represent and signify themselves, even after their deaths. This young people become authors of the crimes and discourses insofar as they intend to keep their memories alive. Such strategy evidences a paradox: in times of major investment in interventions that target the extension of life, they use the untamable power of death to forge a kind of existence that necessarily involves the media image and biological self-annihilation.This phenomenon will be analyzed from the crimes of Cho Seung-Hui, Pekka-Eric Auvinen and Wellington Menezes de Oliveira.

Este artículo analiza los delitos de homicidio/suicidio cometido por jóvenes en instituciones educativas. Nos centramos en los perpetradores que desarrollan productos de comunicación con el fin de subsidiar el trabajo de investigación que hacen los periódicos. Los jóvenes homicidas/suicidas se convierten en autores de crímenes y de discursos en la medida en que tienen la intención de preservar sus memorias.Esta estrategia presenta una paradoja: en tiempos de grandes inversiones en intervenciones dirigidasa la extensión de la vida, los individuos infames utilizan el poder indomable de la muerte para forjar un tipo de existencia que implica necesariamente la imagen mediática del crimen y la auto aniquilación biológica. Este fenómeno será analizado desde los crímenes de Cho Seung-Hui, Pekka-Eric Auvinen y Wellington Menezes de Oliveira.

Mining for Murder-Suicide: An Approach to Identifying Cases of Murder-Suicide in the National Violent Death Reporting System Restricted Access Database.

The National Violent Death Reporting System (NVDRS) is a United States Centers for Disease Control and Prevention (CDC) database of violent deaths from 2003 to the present. The NVDRS collects information from 32 states on several types of violent deaths, including suicides, homicides, homicides followed by suicides, and deaths resulting from child maltreatment or intimate partner violence, as well as legal intervention and accidental firearm deaths. Despite the availability of data from police narratives, medical examiner reports, and other sources, reliably finding the cases of murder-suicide in the NVDRS has proven problematic due to the lack of a unique code for murder-suicide incidents and outdated descriptions of case-finding procedures from previous researchers. By providing a description of the methods used to access to the NVDRS and coding procedures used to decipher these data, the authors seek to assist future researchers in correctly identifying cases of murder-suicide deaths while avoiding false positives.