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The Confidential Inquiry comes of age

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BRITISH JOURNAL OF PSYCHIATRY 1999年第4期175卷 301-302页

作者： Thompson, C Royal S Hants Hosp Southampton SO14 0YG Hants England

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Homicides by people with mental illness: myth and reality

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BRITISH JOURNAL OF PSYCHIATRY 1999年第1期174卷 9-14页

作者： Taylor, PJ Gunn, J Inst Psychiat Dept Forens Psychiat London SE5 8AF England

Background Tragic and high-profile killings by people with mental illness have been used to suggest that the community care model for mental health services has failed. Aims To consider whether such homicides have become more frequent as psychiatric services have changed. Method Data were extracted from Home Office-generated criminal statistics for England and Wales between 1957 and 1995 and subjected to trends analysis. Results There was little fluctuation in numbers of people with a mental illness committing criminal homicide over the 38 years studied, and a 3% annual decline in their contribution to the official statistics. Conclusions There are many reasons for improving the resources and quality of care for people with a mental disorder, but there is no evidence that it is anything but stigmatising to claim that their living in the community is a dangerous experiment that should be reversed. There appears to be some case for specially focused improvement of services for people with a personality disorder and/or substance misuse.

关键词：健康态度社区精神卫生服务/组织和管理英格兰/流行病学杀人/统计学和数值数据纵向研究精神障碍/流行病学精神障碍/心理学舆论暴力威尔士/流行病学人类

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Violent mortality patterns in immigrants in Israel (1990-95)

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MEDICINE SCIENCE AND THE LAW 1999年第2期39卷 173-181页

作者： Karasik, D Yakovenko, K Lipstein, E Hiss, J Tel Aviv Univ Sackler Fac Med Dept Anat & Anthropol IL-69978 Tel Aviv Israel Inst Forens Med IL-61490 Tel Aviv Israel

Since 1989, a large number of immigrants, mostly from the former Soviet Union, have arrived in Israel, increasing the local population (c. 5 million) by 700,000. The morbidity and mortality of this immigant population have been the concern of many investigations. In the present study we examine the mortality pattern of a sample of 1,000 immigrants, whose deaths occurred during the years 1990-95 and were examined at the L. Greenberg (National) Institute of Forensic Medicine. The sample was divided into two subgroups, natural and unnatural, according to manner of death. Seventy-five per cent of the victims in the violent death subgroup were males with a mean age of 44.6 (SD 17.3) years, while the females of the same category were 52.7 years old on average (SD 19.9). The age distribution of the whole sample showed peaks in the 25-34-year-old group for males and the 35-44-year-old group for females. The most frequent causes of death were accident (44.1%), suicide (12.6%) and homicide (7%). In 5% of cases the cause of death could not be determined. The pattern of mortality from violent causes in the immigrant population differed from that of the country of origin in all parameters. The incidence of unnatural death in immigrants resembled the local pattern in Israel, and was significantly lower than that of their homeland.

关键词：事故/统计学和数值数据死亡原因独立国家联合体/人种学杀人/统计学和数值数据以色列/流行病学死亡率自杀/统计学和数值数据暴力/统计学和数值数据成年人老年人女(雌)性人类男(雄)性中年人

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Homicide and suicide risks associated with firearms in the home: A national case-control study

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ANNALS OF EMERGENCY MEDICINE 2003年第6期41卷 771-782页

作者： Wiebe, DJ Univ Calif Los Angeles Sch Publ Hlth Violence Prevent Res Grp Los Angeles CA 90024 USA

Study objective: I test the hypothesis that having a gun in the home is a risk factor for adults to be killed (homicide) or to commit suicide. Methods: Two case-control analyses were based on national samples of subjects 18 years of age or older. Homicide and suicide case subjects were drawn from the 1993 National Mortality Followback Survey. Living control subjects were drawn from the 1994 National Health Interview Survey. Ten control subjects matched by sex, race, and age group were sought for each case subject. Results: The homicide sample consisted of 1,720 case subjects and 8,084 control subjects. Compared with adults in homes with no guns, the adjusted odds ratio (OR) for homicide was 1.41 (95% confidence interval [CI] 1.20 to 1.65) for adults with a gun at home and was particularly high among women (adjusted OR 2.72;95% CI 1.89 to 3.90) compared with men (adjusted OR 1.23;95% CI 1.01 to 1.49) and among nonwhite subjects (adjusted OR 1.74;95% CI 1.37 to 2.21) compared with white subjects (adjusted OR 1.27;95% CI 1.03 to 1.56). Further analyses revealed that a gun in the home was a risk factor for homicide by firearm means (adjusted OR 1.72;95% CI 1.40 to 2.12) but not by nonfirearm means (OR 0.83;95% CI 0.62 to 1.11). The suicide sample consisted of 1,959 case subjects and 13,535 control subjects. The adjusted OR for suicide was 3.44 (95% CI 3.06 to 3.86) for persons with a gun at home. However, further analysis revealed that having a firearm in the home was a risk factor for suicide by firearm (adjusted OR 16.89;95% CI 13.26 to 21.52) but was inversely associated with suicide by other means (adjusted OR 0.68;95% CI 0.55 to 0.84). Conclusion: Having a gun at home is a risk factor for adults to be shot fatally (gun homicide) or commit suicide with a firearm. Physicians should continue to discuss with patients the implications of keeping guns at home. Additional studies are warranted to address study limitations and to better understand the implications of firea

关键词：病例对照研究家庭特征火器/统计学和数值数据杀人/统计学和数值数据 Logistic模型比值比危险因素自杀/统计学和数值数据美国/流行病学青少年成年人老年人女(雌)性人类男(雄)性中年人

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Violence, homicide and suicide: strong correlation and wide variation across districts

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BRITISH JOURNAL OF PSYCHIATRY 1999年第5期175卷 462-466页

作者： Kennedy, HG Iveson, RCY Hill, O Chase Farm Hosp N London Forens Serv Enfield EN2 8JL Middx England Royal Free Hosp Sch Med London England St Lukes Hosp London England

Background The clinical assessment and management of the risk of violence and suicide by people with mental illness may have to focus on environmental as well as individual factors. Aims To investigate possible associations between violence, homicide and suicide rates, population density and indices of deprivation, with particular reference to inner-city boroughs. Method Coroners' statistics in London for homicide and suicide were obtained. with police-reported homicide and violence rates as a validity check. Correlations were made between these data and population density, the Jarman under-privileged areas score, and the Mental Illness Needs Index for each of the 32 London boroughs. Results Homicide rates had a 14.3-fold range, suicide a 4.4-fold range and interpersonal violence a 6.6-fold range. The variables under study were strongly correlated with each other. Rates were highest in boroughs with high population density and deprivation scores. The associations persisted when covarying for deprivation, age structure or population density. Conclusions Because violence, homicide and suicide are so closely correlated. they are likely to be valid indices of the differences between adjacent boroughs;this has implications for the delivery of preventive and mental health services and for clinical management of risk. Declaration of interest None.

关键词：年龄因素杀人/统计学和数值数据伦敦/流行病学人口密度贫困区统计学非参数自杀/统计学和数值数据市区人口/统计学和数值数据暴力/统计学和数值数据青少年成年人老年人儿童儿童学龄前人类婴儿婴儿新生中年人

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Homicides and community care: the evidence

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BRITISH JOURNAL OF PSYCHIATRY 1999年第JUN.期174卷 564-565页

作者： Szmukler, G Thornicroft, G Holloway, F Bowden, P Bethlehem & Maudsley NHS Trust Maudsley Hosp London SE5 8AZ England Inst Psychiat Sect Community Psychiat PRiSM London SE5 8AF England

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Domestic violence and the trauma surgeon

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AMERICAN JOURNAL OF SURGERY 2000年第2期179卷 134-140页

作者： Guth, AA Pachter, HL NYU Sch Med Bellevue Hosp Shock Trauma Unit New York NY USA

BACKGROUND: Domestic violence has become increasingly recognized as a public health problem, and was declared a national epidemic by C. Everett Koop in 1992. In the United States, 1 to 2 million women yearly suffer injuries due to domestic violence, and 30% to 50% of female homicides are committed by a present or former partner. The majority of these murder victims had either been seen in emergency rooms for prior domestic violence-related injuries, or had reported these injuries to the police. It is estimated that 50% of all acute injuries and 21% of all injuries in women requiring urgent surgery are the result of partner abuse. DATA SOURCE: Medline and current literature review. CONCLUSIONS: Health care professionals in the emergency room are an important contact with the victims of domestic violence, and timely identification and intervention can save lives. Overall, upwards of 35% of all emergency room visits by women are the result of domestic violence, whether due to acute injury, problems during pregnancy, or stress-related complaints. Unfortunately, domestic abuse is infrequently disclosed voluntarily by the patient, and often overlooked by the treating physician. Thus, the purpose of this review is to familiarize surgeons with the presentation and management of victims of this hidden epidemic. Am J Surg. 2000;179:134-140. (C) 2000 by Excerpta Medica, Inc.

关键词：虐待儿童/分类虐待儿童/诊断疾病暴发流行家庭暴力/预防和控制家庭暴力/统计学和数值数据急诊室医院/统计学和数值数据杀人/统计学和数值数据妊娠并发症/诊断公共卫生应激心理学/诊断外科学创伤学美国/流行病学创伤和损伤/分类创伤和损伤/诊断创伤和损伤/流行病学儿童女(雌)性人类妊娠

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Violence.

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Journal of health & social policy 1990年第4期1卷 63-68页

作者： Bulhan, H.A. Department of Psychology Boston University MA.

No abstract available for this article.

关键词：非洲裔美国人/心理学家庭卫生杀人/统计学和数值数据少数民族/心理学社会问题美国/流行病学暴力人类

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Intimate partner violence fact sheet.

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International journal of trauma nursing 2000年第2期6卷 66-68页

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Coroner-reviewed infant and toddler deaths - Many ''undetermineds'' resemble homicides

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EVALUATION REVIEW 1997年第1期21卷 58-76页

作者： Sorenson, SB Shen, HK Kraus, JF UNIV CALIF LOS ANGELES SCH PUBL HLTHSO CALIF INJURY PREVENT RES CTRLOS ANGELESCA 90024 UNIV CALIF LOS ANGELES INST NEUROPSYCHIATDIV COMMUNITY PSYCHIATLOS ANGELESCA 90024

Although homicide is a leading cause of death of infants and coddlers, there is some suspicion that an unknown number of additional deaths are unrecognised homicides. The authors used California mortality data from 1969 to 1991 to examine 12,246 injury deaths that occurred before age 5. Characteristics of the dead child, injury event, and postmortem were compared for accidents, homicides, and undetermined deaths. A logistic model was developed to differentiate homicides from accidental deaths and then was used to predict whether undetermined deaths were likely to be homicides or accidents. Unlike accidental deaths, undetermined and homicides had similar distribution patterns of age, race, sex, and place of injury. The predictive model indicates that 43.8% of the undetermined injury deaths were similar to homicides on several characteristics True rates of homicide for infants and toddlers may unfortunately be nearly one fifth and one tenth higher respectively if the undetermined deaths that resemble homicides are token into account.

关键词：事故/统计学和数值数据加利福尼亚/流行病学死亡原因杀人/统计学和数值数据 Logistic模型少数民族/统计学和数值数据比值比试验预期值创伤和损伤/人种学创伤和损伤/死亡率儿童学龄前女(雌)性人类婴儿婴儿新生男(雄)性

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