Psychological Medicine, 1983, 13, 855-860

Printed in Great Britain

The epidemiology of abnormal homicide and murder

followed by suicide
JEREMY COID1
From the Maudsley Hospital, London

SYNOPSIS A comparison of the homicide rate of mentally abnormal offenders and murderers who
subsequently commit suicide, from a range of different populations, shows a uniform consistency
when compared with the overall rates. 'Laws' are proposed which govern the rates within these
subgroups in comparison with the population as a whole and which determine fluctuations.
Qualitatively different psychiatric and sociological factors are thought to account for these findings
and require further elucidation.

psychiatric studies, and the authors commented

INTRODUCTION
Good quality data on mentally abnormal
murderers and murderers who subsequently
commit suicide are surprisingly difficult to find.
The available data are often of doubtful value
because few studies are methodologically com-
parable and thefindingsare rarely related to the
overall homicide rate in the populations from
which the samples are drawn. For example,
Gilles (1976) pointed out that 90 % of his Scottish
male subjects did not have any psychiatric
abnormality, whereas in England and Wales
'over a third of murders are committed [by
people] in an abnormal state of mind, many of
whom commit suicide' (Gibson & Klein, 1969).
This important comparison was based on a large
sample collected over a long period of time, but
taken from an urban area with unique social
features compared with the rest of the country.
No data on the overall rates for Scotland for the
years of study, or for the Strathclyde area, were
given and one is drawn to the inevitable
conclusion that bias could have entered into the
procedure determining whether subjects were
interviewed by the author. A study of homicide
in Iceland (Petursson & Gudjonsson, 1981;
Gudjonsson & Petursson, 1982) has avoided
these errors by describing a complete, but small,
sample over an 80-year period. Theirfindingsare
generally consistent with previous European
1
Address for correspondence: Dr Jeremy Coid, The Maudsley
Hospital, Denmark Hill, London SE5 8AZ.
855
that the studies with the highest rates generally
report substantially lower than average rates for
abnormal homicide. The authors suggested that
abnormal homicide reflects the epidemiology of
the major psychiatric illnesses, whereas the
overall incidence is affected by sociological
factors inherent in different cultures at any one
point in time. This important suggestion is in
need of further clarification.
METHOD
An intensive search of the literature was
conducted with the intention of obtaining rates
within each population, if possible for long
periods of time, for: (1) mentally abnormal
offenders; (2) murder followed by suicide; and
(3) the overall rate of homicide in the population.
Mentally abnormal offenders included cases
(i) who were examined by authors soon after the
offence and were found to be mentally ill; (ii) for
whom the Court returned a verdict of not guilty
by reason of insanity, manslaughter due to
diminished responsibility, or the legal equivalent
according to the country of origin. Care was
taken in separating these subjects from those
who had committed suicide in studies where the
authors had included both groups under the final
heading of Abnormal for statistical comparison
with a Normal group.
Studies frequently did not contain sufficient
data to compute the required rates, and over
856 J. Coid

95% of the potential data base was discarded in

the earliest stages. The most frequent and serious
omission was the overall rate in the population
from which the samples were drawn. An attempt
was made to obtain this missing information, but
only when the alternative source was a publication
by the same official source or group of authors.
For example, Criminal Statistics for Scotland
(1979) fail to give the overall population for the
year of study, but this figure can be obtained
from other official sources. Finally, samples
which clearly bore no resemblance to the rest of
the population were excluded.
RESULTS
Only 12 sources for both abnormal homicide and
murder followed by suicide contained the
required information, or sufficient data to
compute it. Tables 1 and 2 show the comparative
rates for each subgroup, and have been included
to illustrate the wide range of percentages of the
overall population of offenders that are contained
in the mentally abnormal and murder-suicide
subgroups. They range from 2-6% abnormal
among Israeli non-Jews to 26-5% in England and
Wales 1950-9. Similarly, only 3-6% of offenders

Table 1. Comparative rates of abnormal homicide per 100000 population

Rate of
Overall rate % of offenders mentally abnormal
Country Source Years in population mentally abnormal offenders

USA, Philadelphia Wolfgang (1958) 1948-52 610 2-7 016

Israel Non-Jews Landau (1975) 1950-64 400 2-6 010
USA, Albany Co. Grunberg era/. 1977 1963-75 3-50 6-5 0-22
Bermuda Coid (1982) 1920-79 2-35 3-8 009
Canada Schloss & Giesbrecht (1972) 1961-70 1-63 7-7 012
Japan Criminal Statistics 1978 1-60 8-35 013
Japan (1980)
Hong Kong Wong & Singer (1973) 1961-71 1-57 70 011
Scotland Criminal Statistics 1978 1-50 8-9 014
Scotland (1979)
Israel Oriental Jews Landau (1975) 1950-64 107 17-6 018
England & Wales Criminal Statistics (1980) 1970-79 0-88 21-2 018
Iceland Gudjonsson & Petursson (1982) 1940-79 0-72 18-6 013
Israel Western Jews Landau (1975) 1950-64 0-59 200 011
Scotland Gibson & Klein (1969) 1957-68 0-45 8-2 Oil
England & Wales Morris & Blom-Cooper (1967) 1900-49 0-40 21-4 008
England & Wales Morris & Blom-Cooper (1967) 1950-59 0-39 26-5 009

Table 2. Comparative rates of murder-suicide per 100000 population

Overall rate Rate of
Country Source Years in population % murder-suicide murder-suicide

USA, Philadelphia Wolfgang (1958) 1948-52 610 3-6 0-21

USA West (1965) 1959-60 4-50 40 018
Israel Non-Jews Landau (1975) 1950-64 400 6-6 0-26
Bermuda Coid (1982) 1920-79 2-35 5-5 013
Canada Schloss & Giesbrecht (1972) 1967-70 1 90 10-5 019
Australia West (1965) 1959-60 1 70 220 0-36
Hong Kong Wong & Singer (1973) 1961-71 1-57 50 007
Canada Greenland (1971) 1968 1 50 180 0-27
Canada Schloss & Giesbrecht (1972) 1961-66 1 36 15-6 0-21
Israel Oriental Jews Landau (1975) 1950-64 107 25-6 0-27
England & Wales Criminal Statistics (1980) 1969-79 0-88 8-2 007
Iceland Gudjonsson & Petursson (1982) 1940-79 0-72 8-5 006
Israel Western Jews Landau (1975) 1950-64 0-59 67-8 0-40
Scotland Gibson & Klein (1969) 1957-68 0-45 9-2 004
England & Wales Morris & Blom-Cooper (1967) 1900-49 0-40 29-1 011
England & Wales Morris & Blom-Cooper (1967) 1950-59 0-39 33-3 012
Denmark West (1965) 1959-60 0-27 420 0-22
 Abnormal homicide and murder followed by suicide 857

1 USA,

Israel
1 Non-Jews
USA,
si 1 Albany Co.
3 1 Bermuda

Canada

Japan
a i
Hong Kong
i 1
>i 1 Scotland
1978
i 1 Israel
Oriental Jews
a 1 England and Wales
1970-9
Iceland

• Israel

• Western Jews
Scotland
1957-68
0
If 'I
England and Wales
1900-49
D England and Wales
1950-9
1 2 3 4 5 6 7
Rate per 100000

FIG. 1. Comparison of abnormal (S3) and overall (Q) rates of homicide.

committed suicide in Philadelphia 1948-52 in
contrast to 67-8% of Westernized Jews in Israel
(Landau, 1975).
When the overall rates are compared alongside
the two subgroups a striking finding emerges (see
Figs. 1 and 2). There appears to be a remarkable
consistency in the rates of mentally abnormal
offenders when compared with the wide variation
in the overall rates between countries, with
slightly less consistency seen in the results for the
murder-suicide groups.
DISCUSSION
Epidemiological 'laws'
These results enable the association between the
two subgroups and homicide to be reconceptua-
lized in epidemiological terms:
(1) The higher the rate of homicide in a
population, the lower the percentage of offenders
who are found (a) to be mentally abnormal, and
(b) to commit suicide.
(2) The rate of mentally abnormal offenders,
and those who commit suicide, appears to
remain the same in different countries, despite
the considerable differences in the overall rates of
homicide.
(3) There is some indication that the rate of
mentally ill offenders, and those who commit
suicide, remains the same, despite a fluctuation
in the overall rate over time.
Inghe (1941), in a Danish study, showed that
the proportion of mentally abnormal offenders
has an inverse relationship to the prevalence of
the offence in question. It is higher among
relatively unusual, and culturally atypical in-
cidents such as homicide, and lower among
culturally commonplace, more acceptable mis-
 858 J. Coid

USA,
L Philadelphia
USA
Israel
Non-Jews

Bermuda

Cajiada 1967-70

Australia

Hong Kong

Canada 1968

Canada 1961-6
Israel
Oriental Jews
England and Wales
1969-79
Iceland
Israel
Western Jews
Scotland

England and Wales

1900-49
England and Wales
1950-9
Denmark

1 2 3 4 5 6 7
Rate per 100000

FIG. 2. Comparison of murder-suicide ( • ) and overall (Q) rates of homicide.

conduct, such as juvenile delinquency and traffic
offences. Verkko (1967) has further developed
this thesis in relation to the sex ratios of victims
and offenders. He proposed static and dynamic
'laws' governing the proportion of offenders
according to sex, dependent on the overall
frequency of homicide, and also on whether this
frequency is increasing or decreasing. Bohannan
(1967) did not confirm these Maws' in his study
among tribal societies in Africa, but Verkko was
able to substantiate his 'laws' with considerable
data over time and from other cultures.
If the findings of the present study can be
considered 'laws', they are qualitatively and
quantitively different from those of Verkko.
However, they could be re-defined in the same
terms:
(1) Static - in countries with a high frequency
of homicide the proportion committed by the
mentally abnormal and those who kill themselves
is small. In contrast, countries with a low
frequency of homicide have a greater percentage
of mentally abnormal offenders and
murder-suicides.
(2) Dynamic-in countries where the fre-
quency of homicide is increasing, this increase
mainly includes the proportion of normal
offenders. Similarly, when the homicide rates are
decreasing the reduction also primarily affects
the proportion of normal offenders.
 Abnormal homicide and murder followed by suicide
The major weakness of these findings is the
limitations of official sources of criminal statistics
as an indication of the true nature of crime in
society. Homicide is not thought to have escaped
this problem (Radzinowicz & King, 1977), and
comparisons between countries will be further
affected by differing systems of categorization
and the legal process. For example, Bermuda did
not have the verdict manslaughter due to
diminished responsibility during the period of
study, resulting in a comparatively low rate of
abnormal homicide (Coid, 1982). Furthermore,
the data do not match for different years of study
in that the methods of collection differ
considerably between sources, and it is likely that
the psychological assessment of offenders has
become more sophisticated with time. It is
therefore even more surprising to find consis-
tency between such disparate sources.
It can be argued that the findings are not as
convincing for the murder-suicide group, since
Table 2 shows twice the range of variation
between rates as those for abnormal homicide in
Table 1. Variability in recording practices and
the fluctuating suicide rate of the general
population are factors that may partially explain
the greater variance. In England and Wales the
decrease in suicide rate (Office of Health
Economics, 1981) could have contributed to the
decrease in the rate of murder followed by
suicide. West's (1965) study of murder followed
by suicide showed that half of his subjects were
found to be sufficiently abnormal to be regarded
as insane or of diminished responsibility. Or,
stated another way, half were normal and may
have been influenced by the same sociological
factors which affected the normal population.
Implications
Should these 'laws' be confirmed by future
studies, then further research will need to
determine the distinction between variables
affecting rates within these subgroups and the
rest of the population. Not only may they be
qualitatively different, but they may also involve
factors besides the epidemiology of the major
psychiatric illnesses. Lamb & Grant (1982) have
suggested that patterns of care and compulsory
treatment of the mentally ill may profoundly
affect their rates of 'criminalization'. Such
859
factors could account for some of the differences
between rates for the two subgroups in different
countries (Tables 1 and 2), and could partially
reflect differing policies of returning the mentally
ill to the community (Grunberg et al. 1978). A
further area of study suggested by these findings
is their relevance to non-violent crime. Gibbens
(1981) has noted a decline in the percentage of
mentally abnormal shoplifters. However, it
would be important to examine whether this
apparent decline is explained by the rate within
this subgroup remaining static while the overall
rate for the rest of the population has risen.
Finally, these 'laws' may be useful in
delineating more clearly the areas of criminology
that are relevant to clinical study (West, 1980).
This paper was prepared from an M.Phil Thesis,
University of London, supervised by Professor J.
Gunn. I would like to thank Dr Paul Bowden for his
advice, Dr Keiko Sakuta for translation, and the
Home Office Library.
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