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Articles   |    
Psychiatric Characteristics of Homicide Defendants
Christine A. Martone, M.D.; Edward P. Mulvey, Ph.D.; Suzanne Yang, M.D.; Andrei Nemoianu, M.D.; Ryan Shugarman, M.D.; Layla Soliman, M.D.
Am J Psychiatry 2013;170:994-1002. doi:10.1176/appi.ajp.2013.12060858
View Author and Article Information

The authors report no financial relationships with commercial interests.

Dr. Yang was supported by NIMH grant T32 MH16804 and by the U.S. Department of Veterans Affairs, Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment.

The views expressed in this article are those of the authors and do not necessarily reflect the views of the Department of Veterans Affairs or the U.S. government.

From the Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh; the Behavioral Assessment Unit, Allegheny Court of Common Pleas, Pittsburgh; VISN4 Mental Illness Research, Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh; Hennepin County Medical Center, Minneapolis; and Georgetown University Hospital and Saint Elizabeths Hospital, Washington, D.C.

Presented in part at the annual meetings of the American Academy of Law and Psychiatry in Baltimore, Oct. 26–28, 2009, and in Boston, Oct. 27–30, 2011; and at the Third World Congress of the World Association of Cultural Psychiatry in London, March 9–11, 2012.

Address correspondence to Dr. Mulvey (mulveyep@upmc.edu).

Copyright © 2013 by the American Psychiatric Association

Received June 29, 2012; Revised March 18, 2013; Accepted April 26, 2013.

Abstract

Objective  The authors examined the rate of mental disorders in an unselected sample of homicide defendants in a U.S. jurisdiction, seeking to identify psychiatric factors associated with offense characteristics and court outcomes.

Method  Defendants charged with homicide in a U.S. urban county between 2001 and 2005 received a psychiatric evaluation after arrest. Demographic, historical, and psychiatric variables as well as offense characteristics and legal outcomes were described. Bivariate analyses examined differences by age group and by race, and logistic models examined predictors of multiple victims, firearm use, guilty plea, and guilty verdict.

Results  Fifty-eight percent of the sample had at least one axis I or II diagnosis, most often a substance use disorder (47%). Axis I or II diagnoses were more common (78%) among defendants over age 40. Although 37% of the sample had prior psychiatric treatment, only 8% of the defendants with diagnosed axis I disorders had outpatient treatment during the 3 months preceding the homicide; African Americans were less likely than non-African Americans to be in treatment. African American males were more likely to use a firearm and to have a male victim. In exploratory analyses, psychiatric factors did not predict multiple victims, firearm use in the crime, or a guilty verdict.

Conclusions  Rates of axis I disorders were lower than reported in previous studies. Few homicide defendants were in psychiatric treatment at the time of the crime, suggesting limited opportunities for prevention by mental health providers.

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TABLE 1.Characteristics of Homicide Defendants in a U.S. Urban County, 2001–2005a
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a Percentages are based on available data; for some variables, data were missing for some portion of the subsamples.

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b Significant differences between subgroups were observed for the overall sample (p=0.001) and for the group with substance use disorder only (p=0.036).

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TABLE 2.Prevalences of Psychiatric Diagnoses, by Age Group, in Homicide Defendants in a U.S. Urban County, 2001–2005
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TABLE 3.Offense Characteristics in Male Homicide Defendants in a U.S. Urban County, 2001–2005
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a Percentages are based on Ns of 232, 180, and 52 for the three groups, respectively.

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b Percentages are based on Ns of 236, 186, and 49 for the three groups, respectively.

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TABLE 4.Association of Demographic, Historical, and Clinical Variables With Homicide Involving Multiple Victims and Use of a Firearm in a U.S. Urban County, 2001–2005a
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a The models have different sample sizes because cases had different patterns of missing data on the case characteristics and outcome variables. Likelihood ratio chi-square tests were nonsignificant for both analyses.

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b Wald χ²=44.01, p<0.001.

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TABLE 5.Association of Demographic, Historical, Clinical, and Offense Variables With Guilty Plea or Guilty Verdict in Homicide in a U.S. Urban County, 2001–2005a
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a The models have different sample sizes because cases had different patterns of missing data on the case characteristics and outcome variables. Wald chi-square tests and likelihood ratio chi-square tests were nonsignificant for all analyses.

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References

Murphy SL, Xu J, Kochanek KD: Deaths: Preliminary Data for 2010. National Vital Statistics Reports, vol 60, no 4, Jan 11, 2012
 
Cooper  A;  Smith  EL:  Homicide Trends in the United States, 1980–2008: Annual Rates for 2009 and 2010 .  Washington, DC,  US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, 2011
 
Gottlieb  P;  Gabrielsen  G;  Kramp  P:  Psychotic homicides in Copenhagen from 1959 to 1983.  Acta Psychiatr Scand 1987; 76:285–292
[CrossRef] | [PubMed]
 
Fazel  S;  Grann  M:  Psychiatric morbidity among homicide offenders: a Swedish population study.  Am J Psychiatry 2004; 161:2129–2131
[CrossRef] | [PubMed]
 
Lindqvist  P:  Criminal homicide in northern Sweden, 1970–1981: alcohol intoxication, alcohol abuse, and mental disease.  Int J Law Psychiatry 1986; 8:19–37
[CrossRef] | [PubMed]
 
Shaw  J;  Hunt  IM;  Flynn  S;  Meehan  J;  Robinson  J;  Bickley  H;  Parsons  R;  McCann  K;  Burns  J;  Amos  T;  Kapur  N;  Appleby  L:  Rates of mental disorder in people convicted of homicide: national clinical survey.  Br J Psychiatry 2006; 188:143–147
[CrossRef] | [PubMed]
 
Côté  G;  Hodgins  S:  The prevalence of major mental disorders among homicide offenders.  Int J Law Psychiatry 1992; 15:89–99
[CrossRef] | [PubMed]
 
Eronen  M;  Hakola  P;  Tiihonen  J:  Mental disorders and homicidal behavior in Finland.  Arch Gen Psychiatry 1996; 53:497–501
[CrossRef] | [PubMed]
 
Steadman  HJ;  Osher  FC;  Robbins  PC;  Case  B;  Samuels  S:  Prevalence of serious mental illness among jail inmates.  Psychiatr Serv 2009; 60:761–765
[CrossRef] | [PubMed]
 
Gunter  TD;  Arndt  S;  Wenman  G;  Allen  J;  Loveless  P;  Sieleni  B;  Black  DW:  Frequency of mental and addictive disorders among 320 men and women entering the Iowa prison system: use of the MINI-Plus.  J Am Acad Psychiatry Law 2008; 36:27–34
[PubMed]
 
James  DJ;  Glaze  LE:  Mental Health Problems of Prison and Jail Inmates .  Washington, DC,  US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, 2006
 
Teplin  LA:  Psychiatric and substance abuse disorders among male urban jail detainees.  Am J Public Health 1994; 84:290–293
[CrossRef] | [PubMed]
 
Karberg  JC;  James  DJ:  Substance Dependence, Abuse, and Treatment of Jail Inmates, 2002 .  Washington, DC,  US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, 2005
 
Baillargeon  J;  Binswanger  IA;  Penn  JV;  Williams  BA;  Murray  OJ:  Psychiatric disorders and repeat incarcerations: the revolving prison door.  Am J Psychiatry 2009; 166:103–109
[CrossRef] | [PubMed]
 
Yarvis  RM:  Axis I and axis II diagnostic parameters of homicide.  Bull Am Acad Psychiatry Law 1990; 18:249–269
[PubMed]
 
Dwyer  RG;  Frierson  RL:  The presence of low IQ and mental retardation among murder defendants referred for pretrial evaluation.  J Forensic Sci 2006; 51:678–682
[CrossRef] | [PubMed]
 
Frierson  RL;  Finkenbine  RD:  Psychiatric and neurological characteristics of murder defendants referred for pretrial evaluation.  J Forensic Sci 2004; 49:604–609
[CrossRef] | [PubMed]
 
Hanlon  RE;  Rubin  LH;  Jensen  M;  Daoust  S:  Neuropsychological features of indigent murder defendants and death row inmates in relation to homicidal aspects of their crimes.  Arch Clin Neuropsychol 2010; 25:1–13
[CrossRef] | [PubMed]
 
Large  M;  Smith  G;  Nielssen  O:  The relationship between the rate of homicide by those with schizophrenia and the overall homicide rate: a systematic review and meta-analysis.  Schizophr Res 2009; 112:123–129
[CrossRef] | [PubMed]
 
Firth  D:  Bias reduction of maximum likelihood estimates.  Biometrika 1993; 80:27–38
[CrossRef]
 
Heinze  G;  Schemper  M:  A solution to the problem of separation in logistic regression.  Stat Med 2002; 21:2409–2419
[CrossRef] | [PubMed]
 
Koh  KG;  Gwee  KP;  Chan  YH:  Psychiatric aspects of homicide in Singapore: a five-year review (1997–2001).  Singapore Med J 2006; 47:297–304
[PubMed]
 
Reeves  WC;  Strine  TW;  Pratt  LA;  Thompson  W;  Ahluwalia  I;  Dhingra  SS;  McKnight-Eily  LR;  Harrison  L;  D’Angelo  DV;  Williams  L;  Morrow  B;  Gould  D;  Safran  MA; Centers for Disease Control and Prevention:  Mental illness surveillance among adults in the United States.  MMWR Surveill Summ 2011; 60(suppl 3):1–29
[PubMed]
 
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