Associations Between Mental Disorders, Personality Disorders, and Filicide-Suicide and Parental Suicide: A Nationwide Cohort Study.

Aim: Filicide-suicide represents a critical intersection of psychiatric and familial crises, yet the literature remains scant on differentiated risk profiles among family members. This study addresses a gap in understanding the specific mental health correlates of filicide-suicide, especially within a comprehensive family context, distinct from traditional parental or child-focused perspectives.

Method: This study used the Taiwan National Health Insurance Research Database to identify a nationally representative sample of families from 2004 to 2020, with continuous monitoring extending into 2021. Families were classified into those affected by filicide-suicide, parental suicide, and those without such incidents. Multinomial logistic regression was conducted to explore the association between family status and mental health. Analyses of effect modification were conducted to evaluate whether low-income status modified these relationships.

Results: The study encompassed 1,898,299 families, revealing that filicide-suicide is notably rare, with an incidence of 1.64 deaths per 100,000 newborn children from 2004 to 2020, with an increasing trend observed after 2014. Fathers and children in filicide-suicide families had the highest prevalence of mental disorders, followed by those in parental-suicide families and then other families (those where no child has been recorded as a homicide victim and no parent has committed suicide). There was a tendency for stronger associations between filicide-suicide families and paternal schizophrenia as well as autistic spectrum disorder in children among low-income families.

Conclusion: The findings underscore the profound impact of severe mental disorders within the familial framework, emphasizing the need for an integrated approach to mental health care that considers the familial context in order to better predict and prevent such devastating events.