Typology of murder-suicides in Berlin according to a longitudinal study based on autopsy files

Forensic Science, Medicine and Pathology https://doi.org/10.1007/s12024-021-00360-6 ORIGINAL ARTICLE Typology of murder‑suicides in Berlin according to a longitudinal study based on autopsy files Milan Zimmermann1,2 · Michael Tsokos3,4 Accepted: 12 January 2021 © The Author(s) 2021 Abstract Murder-suicides are defined as the murder of at least one person and the suicide of the offender following the murder. The intention to commit suicide must be primary. In most cases, a male offender kills a female victim after a separation. The current analysis was the first analysis of the typology of murder-suicides in Berlin. We analyzed the autopsy files of the Institute for Forensic Medicine of the Charité University Medicine Berlin and of the City Institute for Forensic Medicine Berlin. We performed descriptive and statistical analyses of cases between 2005 and 2013. We identified 17 murder-suicides. All 17 offenders were male, and 20 of the victims (90%) were female. The offenders used firearms in the majority of the cases. In seven cases, the victims and offenders were at least 80 years old. The average age of the offenders was 63 years. Disease was the motive in 6 cases involving older offenders. Our study might support the development of prevention strategies. In this regard, it is important to build a database for murder-suicides in Germany and other countries, to formulate a uniform definition of murder-suicide, to carry out nationwide interdisciplinary studies on this topic and to improve the existing health care structures, especially for older adults and people with depression. Keywords Murder-suicides · Homicide-suicides · Suicides · Criminal law · Depression · Psychopathology Introduction A murder-suicide is defined as the murder of at least one person and the suicide of the offender following the murder. The intention to commit suicide must be primary. The time span between the murder and the suicide as part of the definition of a murder-suicide is controversial. Marzuk et al. [1] defined the maximum time span as one week. The inclusion of a time span in the definition of a murder-suicide might help differentiate between murder-suicide and suicide out of remorse [2]. Most analyses of murder-suicides refer to newspaper articles or forensic files because in most countries, * Milan Zimmermann ‑tuebingen.de 1 Center of Neurology, Department of Neurodegeneration and Hertie‑Institute for Clinical Brain Research, University of Tuebingen, 72074 Tübingen, Germany 2 German Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, 72074 Tübingen, Germany 3 Department of Forensic Medicine, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany 4 City Institute for Forensic Medicine, Berlin, Germany there is no central register for murder-suicides [3]. Data from the USA show that the incidence of murder-suicide lies between 0.2–0.3/100,000/year, which means that 1000–1500 deaths per year occur as part of a murder-suicide [1, 3]. A study based on the data from the National Violent Death Reporting System found 144 cases of murder-suicides, with 164 murders and 144 suicides in 2004 [4]. Liem et al. [5] found that 176 people per year, accounting for approximately 4% of all homicides, die due to a “murder-suicide”. Marzuk et al. [1] found that the offender was male in 94% of the cases and that the victims were female in 85% of the cases. In the study by Bossarte et al. [4], 82.7% of the offenders used firearms and 6% used sharp weapons when committing the homicides. Approximately 65% of the victims were married to the offender or lived in a civil partnership with them [1]. Most offenders were between 40 and 50 years old and most were a few years older than their victims [3]. In most cases, the murder and the suicide occur in the same location [4]. Female offenders of a murder-suicide usually kill their children (48.6%), whereas male offenders usually kill their intimate partner [6]. Domestic violence occurred in 25% of cases before the murder-suicide [3]. Employment was not 13 Vol.:(0123456789) Forensic Science, Medicine and Pathology found to be protective against murder-suicide, as 77% of the offenders had at least one job [3]. Approximately 39% of the offenders had depression [7]. Suicide notes were found in approximately 70% of all cases [8]. The most popular system of categorization, which was introduced by Marzuk et al. [1], is based on possible motives for the murder-suicide. They classified murder-suicides according to the following categories: “amorous jealousy”; “mercy killing”; “altruistic or extended suicides”; “family, financial or social stressors”; and “retaliation”. The category “amorous jealousy” includes murder-suicides in which an offender kills his or her partner after a separation or the announcement of an impending separation. In such cases, perhaps the offender considers the victim to be an extension of himself. “Mercy killings” describe cases of older offenders killing their partners because of declining health or advanced disease. “Pseudo-altruistic” motives might play a role in cases of female offenders killing their children. They might not want them to be completely at the mercy of, for example, a former partner, or to face an unfavorable future [1]. Malphurs and Cohen stated that 70.5% of murder-suicides can be assigned to the category “spousal/consortial”, 10.5% to the category “infanticides”, 8.7% to the category “extrafamilial murder suicides” and 6.5% to the category “familicides” [3]. Another categorization of motives was discussed by Joiner [2] and Adhia et al. [9]. The theory of a “perversion of virtue” involves the misapplication of virtues such as mercy, justice, duty and glory. According to this theory, the offender would consider his offence to be moral [2]. In the current analysis, we analyzed the typology of murder-suicides in Berlin for the first time. This might help support the development of prevention strategies to decrease the frequency of murder-suicides in the future. suicidal intention was primary. Double suicides, in which both participants commit suicide on their own in a timebound and situational context, were not considered. Dual suicides in which both individuals had suicidal intentions but the fatal action was taken by only one person were considered murder-suicides. These included cases in which the participants supposedly mutually agreed to die together, but only one of the participants committed both the homicide and the suicide. Statistics Statistical analysis was performed using IBM SPSS Statistics (IBM Corp. Released IBM SPSS Statistics for Macintosh, Version 22.0. Armonk, NY: IBM Corp.). For the analysis of the demographic data (age of offender and victim), the Mann–Whitney U-test and median test were used. For comparisons between age groups, a chi-squared test was performed. Results Frequency of murder‑suicides We found 17 cases fulfilling the criteria for murder-suicides. These c (...truncated)