complex suicide
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Recent papers in complex suicide
Suicides involving more than one suicide method are termed "complex suicides" and need to be differentiated from murders. Self-immolation is the action of setting fire to oneself and is an infrequent method of suicide method in Western... more
Suicides involving more than one suicide method are termed "complex suicides" and need to be differentiated from murders. Self-immolation is the action of setting fire to oneself and is an infrequent method of suicide method in Western countries. However, burned corpses must be carefully examined because setting fire to a body after death can be a way of covering up a crime. Complex suicides involving self-immolation are rare, but careful analysis is necessary if we are to identify the manner of death. A systematic search of the literature concerning self-incineration in cases of complex suicides was carried out. This covered the age, gender and psychiatric condition of the victims, any history of previous suicide attempts, the existence of suicide notes, evidence of fire accelerants, signs of vital exposure to the fire, toxicology, the other suicide methods used in combination with burning and the characteristics of the burns. 46 cases were found in 22 papers published since 1985, but few of these studies provide any detailed analysis and in several cases many important data were missing. There is, therefore, a need to study this topic and to use an approach based on careful examination of the corpse, detailed investigation of the scene, toxicological examination and an evaluation of the victim's physical and psychiatric state.
Complex suicides involve more than one suicide method. According to the intention of the victim, they are classified as 'planned' when the use of more than one suicide technique has been previously devised by the victim and 'unplanned'... more
Complex suicides involve more than one suicide method. According to the intention of the victim, they are classified as 'planned' when the use of more than one suicide technique has been previously devised by the victim and 'unplanned' when the first method turns out to be too painful or insufficient to cause death, and the individual then resorts to other means of suicide. Complicated suicide, on the other hand, is a term that was introduced by T€ oro and Pollak, in which a failed act of suicide is followed by traumatisation, which has a fatal outcome. This type of death must be distinguished from complex suicides. From a sample of 1160 fatalities (837 males) between 1993 and 2017, we identified 20 (1.72%) cases of complex suicide and three (0.26%) cases of complicated suicide. We considered age, sex, psychiatric history, previous suicide attempts, suicide methods and eventual secondary traumatisation. We also compared planned and unplanned complex suicides. The results show a higher number of planned complex suicides (16 vs. 4), a prevalence of males (n ¼ 17) and adults (median age ¼ 48 years, range 21-74 range). Plastic bag suffocation and gas inhalation (n ¼ 8) were the most commonly used methods. Firearms (n ¼ 4) were used exclusively by males in planned complex suicides. Wrist and forearm cuts (n ¼ 5) were found in four unplanned and one planned complex suicides, and all of the cases with known previous suicidal attempts (n ¼ 3) involved planned complex suicides. Complicated suicides concerned three male victims in two failed attempts of hanging and an unforeseen carbon monoxide intoxication following a non-fatal gunshot to the mouth, confirming the rarity of these fatalities.