Preventing Intimate Partner Murder-Suicide: A Case-Control Study of Suicidal Males in Abusive Relationships

Abstract

Introduction: Murder-suicide is a rare but serious public health problem. It often occurs in the context of intimate partner violence; 62% of murder-suicides in the U.S. involve killing an intimate partner. The goal of this study was to identify the risk indicators for intimate partner murder-suicide among suicidal males with a history of perpetrating intimate partner violence.

Methods: This case-control study used National Violent Death Reporting System data, 2019-2020. Cases were intimate partner murder-suicides committed by males. Controls were males who perpetrated intimate partner violence but who died by suicide without killing their partner. The research team reviewed text summaries from the National Violent Death Reporting System to code detailed information about each event. Analyses estimated the adjusted odds of intimate partner murder-suicide using generalized estimating equations and were completed in November 2024.

Results: Among 478 matched case/control pairs, firearm use (AOR=5.3) and decedent military history (AOR=1.8) were associated with increased odds of perpetrating intimate partner murder-suicide. Prior involvement in a domestic violence protection order (AOR=0.4) and previously established suicide risk indicators (e.g., appearing depressed [AOR=0.4], prior suicide attempts [AOR=0.2], disclosed suicidal intent [AOR=0.2]) were associated with decreased odds of intimate partner murder-suicide.

Conclusions: Among suicidal males perpetrating intimate partner violence, several factors differentiated the risk for murder-suicide relative to that of suicide only. Improving accessibility and implementation of domestic violence protection orders while removing firearms from people who are perpetrating intimate partner violence may prevent intimate partner murder-suicide. There may also be opportunities to screen for and jointly address suicidality and intimate partner violence perpetration across military, healthcare, legal, and child welfare settings.