Suicidal Behavior and Its Relationship with Postmortem Forensic Toxicological Findings

Abstract

Suicide affects all sociodemographic levels, age groups, and populations worldwide. The factors that can increase the risk of suicidal tendencies are widely studied. The aim of this study was to analyze the types and combinations of toxics found in fatal suicide victims with different suicide mechanisms. A total of 355 autopsies were retrospectively studied, and 26 toxics were determined and related to mechanisms of suicide. Hanging (55%), drug overdose (22.7%), and jumping from a height (17.8%) were most represented suicide mechanisms with positive toxicology. Hanging was the most represented in men (50.3%; p = 0.019), while jumping from a height was more represented in women (29.7%, p = 0.028). Drugs of abuse were the most frequent toxics found in men (55.5%; p < 0.001), while medicines were the most frequent type found in women (70.3%, p < 0.001). Alcohol, nordiazepam, cocaine, and venlafaxine were the most consumed toxics. Benzodiazepines and venlafaxine were found in suicides involving drug overdose, hanging, and jumping from a height. In conclusion, most suicides were associated with drug abuse in men. Hanging was more represented in men and jumping from a height in women. Alcohol was present in combination with other toxics and medicines. The toxicological analysis is fundamental to understanding consumption patterns and establishing strategies and protocols for detecting and preventing suicide.

Clinical and Epidemiological Characteristics of Severe Acute Adult Poisonings in French Amazonia: Urgent Need for a Toxicovigilance Monitoring Framework

“…In contrast, in high-income countries, the use of illicit drugs and medicines for suicide was more frequent. Collados-Ros et al [ 65 ] reported that most suicides were associated with drug abuse, mainly psychopharmaceuticals. In this study, the authors highlight the vital role of toxic substances in suicidal behaviors.…”

Toxicological Findings of Self-Poisoning Suicidal Deaths: A Systematic Review by Countries

“…Collados-Ros et al [19] conducted a retrospective study in Spain from 2013 to 2018 on 355 suicide autopsy cases, of which 13% (n = 46) were suicides by poisoning. Toxico-logical investigations revealed the presence of drugs of abuse, pesticides, lorazepam, and carbon monoxide.…”