Suicide risk after homicide in Sweden.

Temporal aspects of suicide risk after homicide using survival analytic method are not fully known and the risk estimates are almost exclusively based on studies of less than 10 years of follow-up. We investigated a population based cohort of 167 Swedish homicide offenders from 1970 to 1980 for which causes of death during the following minimum of 22 years were investigated using survival analysis. Twenty nine suicides (17.4%) occurred during the follow-up representing 30% of the total mortality. A high proportion of suicides (72%) occurred early, within 2 years after the homicide. The suicides continued to accumulate during the following decades after the homicide and the cumulative suicide risk was 18.6%. A very high proportion of violent suicide method (86%) was found. Suicide mortality was heavily skewed towards the first years after the homicide. Homicide offenders have very high short term suicide risk and the suicide risk persists over the entire adult lifespan. Homicide is a strong predictor of future suicide and similar biological mechanisms may be involved in violent criminality and suicidal behavior.