Planned and unplanned complex suicides: Casuistry of the Institute of Legal Medicine of Parma (Italy)

Banchini, Antonio; Schirripa, Maria Laura; Anzillotti, Luca; Cecchi, Rossana

doi:10.1016/j.legalmed.2017.10.005

Cited by 20 publications

(15 citation statements)

References 20 publications

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“…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: 58%

“…noted hanging in 2/2 planned (both involving male victims) and 0/4 unplanned complex suicides. 7 Hanging was highlighted in 9/17 (52.94%) planned and 1/2 (50%) planned complex suicides by Barranco et al. 8…”

Section: Discussionmentioning

confidence: 99%

“…Banchini et al. 7 considered psychiatric conditions in 4/6 (66.67%) victims. One victim was affected by major depression and psychiatric anxiety, another suffered from schizophrenia and one was affected by borderline personality disorder.…”

Section: Discussionmentioning

confidence: 99%

“…Bianchini et al. 7 classified a case of hanging and wrist cuts as ‘planned complex suicide’, but they also affirmed that this case was very difficult to classify accurately due to the lack of important information.…”

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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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Complex and complicated suicides in Friuli (1993–2017)

et al. 2021

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An unusual suicide by self-waterboarding: forensic pathological issues

et al. 2021

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The authors present the first case, to the best of our knowledge, of a preplanned suicide by self-waterboarding. Waterboarding (WB) is a military method of torture in which water is poured into the nostrils and the mouth of a victim, to evoke the sensation of asphyxiation by drowning. The victim was a 22-year-old male student, who was found dead and naked in the bathtub. His head was covered by a soaked canvas bag, and his hands were tied with two nylon ropes and a padlock. The water jet of the showerhead was specifically directed at the victim’s head, so that the canvas bag could be soaked with water. The cause of death was defined as the combination of asphyxiation by drowning with the direct suffocation provoked by the soaked canvas bag in the context of the waterboarding practice. Finally, the authors discuss the differential diagnosis regarding the modality (suicide versus homicide) through which this case of waterboarding was performed. The case is intended to be used as source data for similar forensic cases, where a multidisciplinary approach is advisable in such complex cases.

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