HOMICIDE-SUICIDE IN OLDER PERSONS

Objective: The object ive of this study was to determine the annual in cidence of homicide-suicide and to compare patterns and antecedents in old and young spousal/consortial cases. Method: Homicide-suicide case s were ascertained in four medical examiner districts covering seven e ntire Florida counties from 1988 to 1994. The districts were chosen to determine rates in two regions of Florida, comparable in size of the total population and proportion of older persons. Annual homicide-suic ide incidence rates per 100,000 population and homicide-suicides as a percentage of total homicides and total suicides separately were calcu lated by age group and Florida region. Complete medical examiner files were obtained and 160 variables were coded from medical examiner repo rts to compare features and clinical characteristics by age and region . Results: Annual incidence rates ranged from 0.3 to 0.7 per 100, 000 for persons under age 55 and from 0.4 to 0.9 per 100,000 for persons a ge 55 and older, With higher rates in the older group every year but t wo. Cases of spousal/consortial homicide-suicide were the most common in both age groups. The younger couples in both regions were comparabl e, except for racial composition, but the older couples differed. West central Florida couples were in their seventies, Caucasian, usually m arried, and both ill poor health; and there were indications of depres sion or alcohol abuse in half the perpetrators. Two-thirds of the sout heastern Florida couples were Hispanic; there was a mean age differenc e of 18 years between perpetrators and victims; and verbal discord, ph ysical violence, and separation were prominent antecedents. Conclusion s: The base rate for homicide-suicide in both age groups was higher th an that reported in previous studies. Spousal/consortial homicide-suic ides were the dominant form, and although psychopathology was strongly implicated, homicide-suicides are violent lethal acts resulting from additive or multiplicative effects of-diathesis, including culture, an d stressful experiences.