Homicide followed by suicide is a rare but tragic event. Psychiatrists and mental health professionals are often called upon to comment publicly on the event or to help the "hidden victims," the survivors of the tragedy. There were 39 such cases in Quebec between 1988 and 1990, and they have been reviewed through the examination of the coroner's files. The epidemiological rates of homicide, suicide, homicide-suicide and the sociodemographic and clinical characteristics of the perpetrators and victims are presented and compared with the international literature. Sociological and psychopathological hypotheses are presented with a special reference to the possibility of various subgroups of perpetrators. Research needs to be pursued along the lines of more detailed case studies of psychopathological characteristics using the psychological autopsy approach. The reconstruction of the couple's relationship and of the final circumstances leading up to the tragedy may provide warning indices that could be helpful in preventing such tragedies.

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In what way is the bereavement process following suicide different from other types of bereavement? The participants were 30 survivors of suicide and 30 survivors of car accidents who were interviewed twice at an average of six months, and the second measure was taken at an average of nine months after the death, with standardized questionnaires to measure depression and grief reaction. Measures of shame, social support, family adaptation, psychological distress, and prior losses were also obtained during the second interview. All survivors were parents who had lost a son aged between 18 and 35 years. The results indicate that suicide survivors were more depressed than accident survivors at the first measure but this difference disappeared at the second measure. Survivors of suicide experienced greater feelings of shame and had experienced more life events after the death than did accident survivors. There was also a greater history of loss in parents bereaved by suicide. Parental bereavement after suicide appears to differ in several ways from other types of bereavement and appears to happen more often in vulnerable families.

Based on recent literature in which obesity is considered a psychosomatic disease, the authors present results of a study attempting to identify the degree of alexithymia and symbolic function inhibition in two overweight groups (moderately and morbidly obese) and compare the results with a normal-weight control group. The sample was composed of 95 subjects divided into three groups. The results revealed that the two obese groups were generally more alexithymic and had a higher degree of symbolic function inhibition than normal-weight controls. Nevertheless, the two alexithymia measures used in this study disclosed inconsistent results. The data are discussed in terms of etiological, methodological and treatment implications.

Suicide-bereaved families have been described as more depression-prone and their bereavement process as more complicated and difficult. Few studies have aimed specifically to investigate the history of transgenerational childhood loss in suicide survivor families as an indicator of greater vulnerability. Childhood separation experiences are associated with difficulties in forming and maintaining attachments. Bonding difficulties are also associated with greater vulnerability to depression and may constitute a suicide risk factor. This exploratory study (n = 32) focused on two groups, each of 16 mothers who had lost a son to suicide and car accidents, respectively. History of loss and early separation experiences were investigated through a clinical interview of the bereaved mothers and through a psychological autopsy of the deceased sons. Results indicate significant transgenerational indices of loss, separation, and inadequate child-rearing. Pre-death life events and adversities in the family may be as important to bereavement outcome as post-death happenings. The cycle of these events, the role of fathers and the role of protective factors must be further studied using detailed life-course reconstructions.