Combined homicide-suicides have been classified based on the psychopatholog
y of the perpetrator and the nature of the relationship between perpetrator
and victim(s). To further understand the nature of this tragic phenomenon
and to test the validity and practicality of a previously suggested classif
ication system, investigators systematically collected data on all combined
homicide-suicide events that occurred in Galveston County, Texas over a co
ntinuous 18-year period (n = 20). The most common psychopathological findin
g for perpetrators was high serum alcohol levels that suggested intoxicatio
n. Most combined homicide-suicides fell into one of the relational categori
es and most of these, as predicted, were of the consortial type, possessive
subtype. As expected, due to the small sample size, the less common types
of combined homicide-suicide were not represented in this sample.