Forensic pathological study of complex and complicated suicides: A twelve-year case series in Genoa (Italy)

Barranco, Rosario; Diana, Carole; Ventura, Francesco

doi:10.1016/j.jflm.2019.04.007

Cited by 23 publications

(22 citation statements)

References 21 publications

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“…In the forensic literature, complex suicides represent 1.5–5% of overall suicides, 4–6,8,10,11 and the incidence identified in our study is within this range. The ratio between planned and unplanned complex suicides is variable.…”

Section: Discussionsupporting

confidence: 69%

“…This type of fatality is more frequent in males. 14 A male-to-female ratio of 8/7 5 or the presence of only male victims 4,7 in primary combined suicides and ratios of 15/2 8 , 27/12 5 , 4/1 4 and 2/2 7 in unplanned complex suicides were observed in previous studies. We noted a clear male prevalence in planned complex suicides and a male-to-female ratio of 1:1 in unplanned complex suicides, although the two samples were not balanced.…”

Section: Discussionsupporting

confidence: 57%

“…Barranco et al. 8 reported 17 (89.5%) unplanned and two (10.5%) planned complex suicides. On the contrary, Racette and Sauvageau 4 and Bohnert 2 observed 14/19 (73.68%) and 70/89 (78.65%) primary and 5/19 (26.32%) and 19/89 (21.35%) secondary combined suicides, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…6,8,10 Many cases are described among people in their fifth decade, although some cases are reported amongst older people. 2,5,8,12,13 In one study, the victims of planned complex suicides tended to be older than the victims of unplanned complex suicides. 4 Our outcomes did not differ from previous research.…”

Section: Discussionmentioning

confidence: 99%

“…Most of the literature concerning multimodal suicides consists of case reports, while systematic studies are rare. 4–8 This retrospective study analyses all the cases of complex and complicated suicides in our records and compares the results with the existing literature.…”

Section: Introductionmentioning

confidence: 99%

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Complex and complicated suicides in Friuli (1993–2017)

et al. 2021

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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 Töro 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 = 17) and adults (median age = 48 years, range 21–74 range). Plastic bag suffocation and gas inhalation ( n = 8) were the most commonly used methods. Firearms ( n = 4) were used exclusively by males in planned complex suicides. Wrist and forearm cuts ( n = 5) were found in four unplanned and one planned complex suicides, and all of the cases with known previous suicidal attempts ( n = 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.

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