The incidence of homicide-suicide events among elderly people in the US is rising, with most cases involving a husband who kills his wife and then himself, according to an article in the March issue of the American Journal of Geriatric Psychiatry.

In order to identify factors that distinguish elderly married men who kill their wives versus peers who kill only themselves, American researchers examined case facts in 20 spousal homicide-suicides in Florida involving men over age 55 over a two-year period (1998, 1999) and compared those men to older men who only committed suicide.

“We found that the men who committed homicide against their wives and then suicide either displayed more domestic violence against their wives or they were caregivers to their wives,” said coauthor Julie Cohen, PhD. “Those who committed suicide were more likely to have health problems themselves and were receiving care from their wives. Men in both categories had suffered depression.”

According to Cohen, depression played a role in both kinds of events, but the factors in homicide/suicide cases included the caregiving strain.

“The men who killed their wives and then themselves were generally older than their wives, who were probably unknowing victims,” concluded Cohen. “These events were not altruistic or based on suicide pacts. Their motivations are complex. Ours was the first study to case-control test the hypothesis that the difference between homicide/suicide and suicide alone in older men will differ on psychosocial factors.”

The study found that 25 percent of homicide-suicide men had a history of domestic violence while only 5 percent of the control suicide only subjects had such a history. Almost half (40 percent) of the homicide-suicide perpetrators were caregivers for their wives, but none of the suicide subjects were caregivers. All of the homicide-suicide men used a gun. Nationally, 72 percent of older men who commit suicide use a gun.

Cohen emphasized that depression played a significant role in both cases, as did medical illness, which contributed to 60 to 90 percent of suicides in older persons.

“The interaction between factors, such as marital-relationship variables and illness should be examined in future studies,” said Cohen, who also serves as the director of the Clinical Division of the American Association of Suicidology, an organization dedicated to the understanding and prevention of suicide. “The aging population will challenge researchers, clinicians and other health care professionals to identify these factors and then design appropriate interventions for this vulnerable group.”