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3 results

  • Psychotic symptoms in mass shootings v. mass murders not involving firearms: findings from the Columbia mass murder database

  • Gary Brucato, Paul S. Appelbaum, Hannah Hesson, Eileen A. Shea, Gabriella Dishy, Kathryn Lee, Tyler Pia, Faizan Syed, Alexandra Villalobos, Melanie M. Wall, Jeffrey A. Lieberman, Ragy R. Girgis
  • Journal:
    Psychological Medicine / Volume 52 / Issue 15 / November 2022
    Published online by Cambridge University Press:
    17 February 2021, pp. 3422-3430
  • Background

    Mass shootings account for a small fraction of annual worldwide murders, yet disproportionately affect society and influence policy. Evidence suggesting a link between mass shootings and severe mental illness (i.e. involving psychosis) is often misrepresented, generating stigma. Thus, the actual prevalence constitutes a key public health concern.

    Methods

    We examined global personal-cause mass murders from 1900 to 2019, amassed by review of 14 785 murders publicly described in English in print or online, and collected information regarding perpetrator, demographics, legal history, drug use and alcohol misuse, and history of symptoms of psychiatric or neurologic illness using standardized methods. We distinguished whether firearms were or were not used, and, if so, the type (non-automatic v. semi- or fully-automatic).

    Results

    We identified 1315 mass murders, 65% of which involved firearms. Lifetime psychotic symptoms were noted among 11% of perpetrators, consistent with previous reports, including 18% of mass murderers who did not use firearms and 8% of those who did (χ2 = 28.0, p < 0.01). US-based mass shooters were more likely to have legal histories, use recreational drugs or misuse alcohol, or have histories of non-psychotic psychiatric or neurologic symptoms. US-based mass shooters with symptoms of any psychiatric or neurologic illness more frequently used semi-or fully-automatic firearms.

    Conclusions

    These results suggest that policies aimed at preventing mass shootings by focusing on serious mental illness, characterized by psychotic symptoms, may have limited impact. Policies such as those targeting firearm access, recreational drug use and alcohol misuse, legal history, and non-psychotic psychopathology might yield more substantial results.

  • Guns and psychiatry: what psychiatrists need to know

  • Part of
  • Ann M. Mortimer
  • Journal:
    BJPsych Advances / Volume 26 / Issue 1 / January 2020
    Published online by Cambridge University Press:
    10 May 2019, pp. 41-47
    Print publication:
    January 2020
    • Article
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  • The private ownership of firearms for participation in shooting sports, subject to a rigorous process of certification by the police, is not uncommon in the UK. Primary care medical involvement in this process is currently a contentious issue. The mental health of firearms owners is clearly germane to public safety: suicide is by far the greatest concern, alongside security breaches. Homicide committed with legally held firearms is very rare: there is very little cross-over between legitimate shooting sports and crime involving firearms. The perpetrators of family annihilation and single-incident mass killings using firearms in the UK have not been known to psychiatry, although a minority have been found to be mentally disordered post hoc. Regarding suicidality, there is little if any difference between those at risk who own firearms and those who do not, excepting that firearm suicide attempts are highly likely to be fatal. Guidance is offered in this article on the identification of patients who own firearms, the evaluation of risks and how to manage these in practical terms.

    LEARNING OBJECTIVES

    After reading this article you will be able to:

    • • demonstrate a basic knowledge of varieties of sporting firearms and understand the differences between legitimate and criminal use of firearms in the UK

    • • appreciate mental health problems related to the private ownership of firearms and the risks of suicidality

    • • understand the role of the police in certification and how to raise concerns when a patient's access to firearms is an issue.