A case-control study of filicide/infanticide in 90 mothers

This study aims to explore the clinical and socio-demographic characteristics of 30 women who committed filicide and compare them to those of 60 postpartum women who did not commit filicide, including 30 with severe postpartum mental illness and 30 without a known history of psychiatric disorders. Clinical assessment included a face-to-face interview with the Structured Clinical Interviews for DSM-IV Axis I and Axis II Disorders. Information on socio-economic, medical, and personal factors was collected using the Clinical Interview for DSM-IV and organized in a clinical vignette and OPCRIT ratings. Consensus best-estimate diagnoses were made according to DSM-V criteria. Inference was conducted using Fisher's exact test for categorical variables and Mann-Whitney U rank test for continuous variables. Family history of violent death, psychotic symptoms (OR 8.3; CI 95% 2.26-36.13), severe insomnia (9.8; 2.28-61.75), and a schizophrenia spectrum or bipolar diathesis (4.8; 1.22-23.86) were associated with history of filicide. Rates of history of sexual abuse in childhood were higher in both the filicide and the severe postpartum mental illness groups compared to healthy controls (6.7; 1.25-70.46 and 7.8; 1.47; 80.47 respectively). Conversely, we did not observe any difference in the rates of history of sexual abuse in adulthood across groups. The lack of adequate postpartum psychiatric care was an important precipitating factor in many cases of infanticide and even late filicide. This study underscores the need for increasing awareness by health care professionals and the wider society of the complex dynamics and psychiatric risks associated with motherhood.