Suicide trends in upper egypt

Suicide is an important problem, ranking among the top 10 causes of death for individuals in all ages in developed countries. This article is a retrospective study evaluating suicide cases in Assiut, one of the largest provinces in Egypt, from 2005 to 2009. There were 117 cases, of which involved 68 male victims (58.12%) and 49 women (41.88%). Suicide rates ranged from 0.6 to 0.8 per 100,000. Age predominance was from 20 to ≤30 years. The method of suicide was different between male and female victims, as male victims tried to use more violent methods than females. The most common cause of death in men was usage of toxins and by hanging 29% and 28%, respectively, while in women was usage of toxins (70%). This study showed that suicide rates have increased since 1987, indicating a grave problem that needs to be solved.     

Adolescent and young adult suicide: a 10-year retrospective review of Kentucky Medical Examiner cases

The compilation of all suicidal causes of death attained the third highest ranking of mortality between the ages of 15 and 24 following unintentional deaths and homicide in the United States, accounting for approximately 4000 deaths in 2002. A variety of biopsychosocial factors may contribute to adolescent suicidal behavior, including psychiatric disorders, risk-taking behaviors, and lack of a cohesive family unit. The authors conducted a 10-year (1993-2002) retrospective review of 108 Medical Examiner cases of suicide ages 11-17 and 358 cases ages 18-24 in Kentucky, which represents two thirds of the Coroner cases in the state. The majority of victims were male and Caucasian. The major causes of death were the same for the two age groups, specifically, firearm injury (72.2% and 70.7%), hanging (22.2% and 18.7%), and drug intoxication (2.8% and 5.3%). An integrated Coroner-Medical Examiner system profits in the public health arena by providing collaborative research data for policy decisions. The prevalence of youth suicide by firearm should prompt further discussion regarding ways to better identify high-risk adolescents and young adults and restrict pediatric access to unsecured household firearms.     

Self-immolation Suicide in Greece: A Forensic Psychiatric Autopsy Study between 2011 and 2019

Self-immolation is a rare suicide method in the developed countries of the western world (0.06–1%); however, it has relatively higher prevalence rates in the developing countries of Asia and Africa (6–57%). The present study aims to examine self-immolation suicides within the Greek mainland (Attiki, Thrace, and Peloponnese) over a period of 9 years (2011–2019) in order to investigate the phenomenon in the Greek population forensically, identify the characteristics and motivations of suicide victims, explore its associations to socio-cultural or psychiatric factors, and describe a fatal case of suicide by self-immolation that was partially recorded on camera. The medical files (autopsy reports) of cases performed at the Departments of Forensic Medicine of the National and Kapodistrian University of Athens, Democritus University of Thrace, and the Forensic Service of Messinia—Peloponnese were retrospectively examined yielding 19 cases of suicides by self-immolation. A 3.7% prevalence of suicide by self-immolation among suicide fatalities within the Greek population was estimated. A distinctive feature of the Greek population regarding self-immolation was disclosed that it is being practiced predominantly by the elderly (mean age 2–3.5 decades higher than other countries). The phenomenon correlated strongly with poorly controlled mental disorders (mostly affective and adjustment disorders). Unlike other countries, there was no significant association with domestic or sexual violence, social or political protest, or religious issues. Therefore, the suicide victims preferred secluded or private outdoor locations (not public). Findings deriving from the examined variables localize Greek population culturally between the Western European and Asian African countries, but with its own idiosyncrasies.     

Shooting Through Clothing in Firearm Suicides

Abstract: There is a longstanding empirical rule that people who commit suicide rarely shoot through their clothing, but rather put it aside to expose the nude skin. Signs of shots through clothing have always been considered suspicious, raising presumptions of the presence of an abettor. Our report, based on a retrospective study of fatal suicidal firearm injuries from the years 1980 to 2007, points out that suicide victims only rarely remove clothing from the site of the future entry wound. The report covered 43 cases with fatal gunshot wounds in the area of the thorax, with only four persons (9%) removing the clothing present in the area of the subsequent self‐inflicted wound. Defects present on the clothing of a victim cannot, therefore, be understood as an absolute criterion for disproving the possibility of suicide, and nor do they necessarily indicate an unfortunate accident or homicide. If, however, the suicide victim removes the clothing from the area of the future wound, then this is almost always an indication of suicide.     

Homicide‐Suicide in Konya,Turkey Between 2000 and 2007*

Abstract: Homicide followed by the suicide of the murderer is a relatively rare lethal incident in which an individual kills another person and subsequently dies by suicide. Cases involving a homicide and a suicide in which death examinations and autopsies were performed at The Konya Branch of the Forensic Medicine Council between 2000 and 2007 were retrospectively investigated. During the studied time period, there were 10 homicide‐suicide cases identified with 10 perpetrators killing 12 victims. Nine of the perpetrators were men and eight of the victims were women. The precipitating motive was an impending divorce in four of the cases. Two perpetrators were described as severely depressed, one had a diagnosis of antisocial personality disorder, and one was a pedophile who had reactive depression. Firearms were used in eight of the homicide cases and seven of the suicides. Constricting the use of firearms may reduce/prevent future homicide‐suicide cases, as it is the most commonly used method to carry out homicide‐suicides.     

Suicide under the age of eighteen: a 10-year retrospective study

The number of suicides in the pediatric age group is rising, and death investigators need to be aware of the common scenarios, risk factors, and victims as they investigate such cases to properly assign the cause and manner of death. We reviewed all pediatric cases referred to the Medical University of South Carolina, Forensic Section, from January 1988 through January 1998. Thirty-one cases of pediatric suicide were analyzed with regards to age, gender, race, cause of death, surrounding circumstances, and past history. Sixty-eight percent of victims were aged 16 or 17 years, 84% were male, 68% were white, 78% used firearms to commit suicide, 81% were found within close vicinity of their home, and 26% had a documented history of mental illness. Suicide is a manner of death that is often difficult for the public to accept, especially in pediatric cases. We report our findings in this 10-year retrospective study to better understand this entity and work toward the prevention of future cases.     

Suicides in the young people of Geneva, Switzerland, from 1993 to 2002

Suicides in Geneva in those less than 25 years old, from 1993 to 2002, were reviewed. Scenes investigations, autopsy findings, toxicology results, and psychiatric history (when available) were examined. There were 65 cases. The average annual suicide rate was 11/100,000. Seventy-seven percent were male, and 23% were female. The youngest was 12 years old and most of the victims were 18 years old and over (89%). For men, the use of firearms was the most common method (38%), followed by fall from height (16%) and drowning (10%). For women, fall from height was the most frequent (40%), followed by firearms and medication overdoses (20% each), hanging (13%), and drowning (7%). Toxicological analysis was performed in 41% of the cases and showed that alcohol was present in 26% and other drugs in 67% of these cases. The most common drugs present were benzodiazepines, cannabis, and cocaine.     

Suicide Pacts: Six Cases and Literature Review

A suicide pact is the decision of two or more people to die together. This event is rare. The majority of suicide pacts victims are married, socially isolated, with a serious physical illness in one or both partners. We performed a retrospective study of all cases of suicide pacts leading to death between January 1, 2003 and December 31, 2010 referred to the Forensic Medicine Department of Tours (France). Six cases were recorded as suicide pacts. Firearms were the preferred means of death. Five suicide notes were discovered. For some cases, it was difficult to establish whether death was the result of a suicide pact or of a homicide–suicide without the consent of the victim. An objective element, such as a suicide note and motive, is required to prove that a suicide pact is involved. The prevalence of mental disorders is hard to assess. In France, psychological autopsies are not performed in such cases, as the investigation is usually very sparse after the death of both individuals.     

A Ten‐year Study of Suicides from a Rural/Suburban County

This study will discuss trends in suicide data compiled over 10 years in Dutchess County, NY, from 2004 to 2013. These data were based on reporting and examination standards recommended by the National Association of Medical Examiners and Department of Justice death investigation standards. Almost 300 cases were analyzed in terms of the deceased's gender, age, race, method of suicide, and weapon used. Results from this study agree with other reports showing significant differences for method of death both in terms of age and gender, with men more likely to choose firearms and women more likely to choose overdose. Furthermore, older persons were more likely to commit suicide by firearms, and the younger persons were more likely to commit suicide by overdose. However, other areas, such as method of suicide, differ from national statistics.     

Fire and suicide: a three-year study of self-immolation deaths.

Thirty-two self-immolation deaths by fire, representing about 1% of suicides, occurred in the province of Ontario (population 9 million), Canada, from 1986 through 1988. The victims, mostly male (male/female ratio, 26:6), were between 21 and 71 years old (mean age, 38 years). Although the scene of self-immolation was usually familiar to the deceased, some chose remote locations. Eleven were found dead in motor vehicles. An accelerant, usually gasoline, was used in most cases. Many of these individuals had, at some time, indicated their intent to commit suicide, a few by self-immolation, but only about half had a diagnosed psychiatric illness. Most of the victims had a reason to kill themselves, but the factors that motivated them to chose self-immolation by fire were uncertain. Fourteen individuals died in hospitals from severe burn complications. The remainder were found dead at the scene. The postmortem findings of soot in the airway and elevated carbon monoxide in the blood of most of these victims [the carboxyhemoglobin (COHb) concentration was in one case less than 10%, in ten cases greater than or equal to 10 to 50%, and in seven cases greater than 50%] were helpful in determining that the individuals were not only alive at the time of the fire but also that a significant number died from smoke inhalation and carbon monoxide poisoning. The highest levels of carbon monoxide were observed in victims discovered in motor vehicles.     

Child Suicide in the North of Portugal

Suicide in children is a rare finding and is probably motivated by acts of impulsiveness. This study aims to contribute to the characterization of child suicide in a forensic perspective in the Portuguese population. Data of forensic autopsies from 2004 to 2012 related to suicide victims under 18 years were reviewed. A total of 17 cases, with a male predominance (64.7%) and a mean age of 15.24 ± 1.348 for both genders, were registered. The leading suicide method was hanging (35.3%), and a suicide note was found in 41.2%. Psychological autopsy proved to be useful in promoting a better understanding of these incidents and their antecedents. This study also offers useful information, namely the implied risk factors, for future programs of suicide research and prevention.     

Inhalant deaths in South Australia: a 20-year retrospective autopsy study

A 20-year retrospective study of inhalant deaths in South Australia, autopsied at Forensic Science SA, was undertaken from January 1983 to December 2002. Thirty-nine cases were identified from an autopsy pool of 18,880 cases, with a male to female ratio of 12:1. Sixty-four percent of the victims (N = 25) died during voluntary inhalation of volatile substances and 28% (N = 11) committed suicide utilizing a volatile substance or gas. The remaining 3 cases involved a workplace accident (N = 1) and 2 cases of autoerotic death where inhalants were being used to augment solitary sexual activity. The mean age of the 28 victims of accidental inhalant death of 21 years (range, 13-45 years) was considerably less than that of the 11 suicide victims of 31.5 years (range, 17-48 years). No homicides were found. Approximately one quarter of the victims were Aboriginal (N = 11), 10 of whom had died as a result of gasoline inhalation ("petrol sniffing"). Other common substances of abuse were aliphatic hydrocarbons such as butane. The study has shown that those most at risk for accidental or suicidal inhalant deaths were young males, with 92% of victims overall being male, and with 77% of victims being under 31 years of age. Gasoline inhalation remains a significant problem in Aboriginal communities in South Australia.     

Influence of ballistic and autopsy parameters on the manner of death in case of long firearms fatalities

A retrospective study was carried out on 132 fatalities due to gunshot wounds secondary to long firearms. One group of suicide (n=72) and one group of homicide (n=60) were statistically compared regarding age and sex of the victim, number of shots, range of fire, direction of the projectile(s), anatomical distribution of entrance sites, weapon and ammunition types and the nature of eventual associated traumatic lesions. The frequency of suicide was higher when the victim's age increased. Females constituted about 43% of the homicide victims and about 8% of the suicide victims. 51.5% of the homicide victims and about 10% of the suicide victims had sustained more than one gunshot wound. Close range was respectively found in 53.5% of the homicide cases and in all suicide cases. Most of the suicide cases (85% of the cases) showed typical entrance sites. Entrance sites in the limbs and lateral or posterior wall of the chest were only encountered in homicide cases. Associated traumatic lesions were found in about 23% of the homicide cases and in 18% of the suicide cases. In case of suicidal gunshots to the left chest, both upwards and downwards directions, and also both right-to-left and left-to-right directions can occur. From 22 suicide cases showing entrance wound in the mouth, a downwards direction was found in only one. This study underlines the importance but also the limits of the autopsy findings (including direction of the projectile(s) related to the entrance site) for giving an indication of the manner of death (homicide vs. suicide).     

Are there environmental factors influencing the choice of death by drowning as a means of suicide in the Geneva canton?

123 out of 850 suicides that occurred in the Canton of Geneva between 1980 and 1989 were suicides by submersion. 75 women and 48 men committed this kind of suicide. 89 victims (57 women and 32 men) were older than 40 years. In all cases the spatial distance between the residence of the suicides and the nearest river or lake was determined; a correlation with the tendency to commit suicide by drowning was not evident. More than geographical factors, the psychological influences have to be considered.     

Filicide-suicide in Chicago, 1870-1930

Filicide (the killing of a child by a parent) followed by the offender's suicide is a tragic but, fortunately, rare event. The contexts and circumstances surrounding filicide-suicide may provide insight into parental psychology. The authors test several hypotheses about filicide-suicide using a database including incident-level information on 11,018 Chicago homicides during 1870-1930. The results provide some support for the hypothesis of differential risk of suicide following filicide by genetic parents and stepparents and replicate previous research indicating that filicides with multiple victims are more likely to end in the offender's suicide than are filicides with a single victim; parents are more likely to commit suicide following the filicide of an older child than of a younger child; and older parents, relative to younger parents, are more likely to commit suicide following filicide. The discussion situates these results within the existing literature and highlights important directions for future research.     

Self-inflicted burns: the value of collaboration between medicine and law

Self-inflicted burns are rare in France, but they lead to major, often life-threatening complications. The authors reviewed medical data for patients hospitalized in a burn center from January 2004 to December 2008. Thirty-eight cases of self-inflicted burns were compared with 220 accidental burns. Women were predominantly affected (57.9%, n = 22). A psychiatric history (71%, n = 27) was more frequent in this population. The mean age of the victims was 38 years. The leading method of suicide was flame (94%, n = 36) associated with gasoline used as an accelerant (77.7%, n = 28). Mean total burn surface area (41.5%) and mortality (36.9%) were higher in the self-inflicted burn population. By recognizing epidemiological characteristics and patients at risk, we can better classify lesions related to self-immolation. It is important for the forensic physician to consult survival details to correlate these data with the results of autopsy.     

河南省刑事案件司法精神病学鉴定案例的随访研究

目的研究司法精神病学鉴定后各方对结论及处理的看法及社会影响等随访因素。方法作者通过通信函调、电话随访和登门拜访等三种方法,用自编调查表对208例鉴定案例分别向委托机关、被鉴定人本人或家属、受害人本人或家属进行随访。结果被鉴定人受教育年限平均为4.84年,以30岁左右已婚男性农民居多。暴力犯罪(129例占83.77%)远较非暴力犯罪(25例占16.23%)为多,前者又尤以杀人(44例占28.57%)为最常见。本资料再鉴定率为2.93%。被鉴定人及其家属对34例无责任能力的处理意见认为恰当的占76.47%,对判为无罪释放的28例,认为处理恰当的占71.43%,认为不恰当的占10.7%。对就医者几乎全都满意,对判刑或关押的认为恰当与不恰当者各占43.18%。受害人目前现状为死亡7例,残废10例,恢复健康10例。被鉴定人及其家属的意见与司法机关认为案件引起的社会影响似乎无关。被司法机关无罪释放的41例(26.62%)被鉴定人中,再杀人2例(4.87%),放火2例(4.87%),盗窃2例(4.87%),回归社会后有破坏行为但尚未构成犯罪者3例(7.31%)。结论建议政府有关部门尽快建立违法犯罪精神病人的监管和医疗机构。     

Suicide behind bars: trends, inconsistencies, and practical implications

The results of two comprehensive approaches are compared: the nationwide surveys of suicides in U.S. jails by Hayes and the international meta-analyses of suicides in jails and prisons by Fazel et al. Factors are classified as demographic, situational, clinical, and methodical. More than 50% of U.S. jail suicide victims were men, white, unmarried, under 28 years of age, charged with minor or drug-related offenses, and intoxicated with drugs or alcohol. Suicides significantly occurred in isolation. Suicide victims in the international study were significantly (p < 0.001) men, white, married, pretrial, and charged with or convicted of violent offenses. Psychiatric diagnosis, alcohol abuse, taking psychotropic medication, and suicidal ideation were also positively correlated in the international study, but suicide victims were distributed more evenly over age-groups. Results of other studies illustrate the near universality of some findings. Three theories of suicide are briefly discussed.     

Planned and unplanned complex suicides: a 5-year retrospective study

The notion of planned and unplanned complex suicides first appeared in 1974 by Marcinkowski and, since then, no systematic study of complex suicides has been published in the English forensic literature. Here, the authors present a 5-year retrospective study of complex suicides. Nineteen complex suicides were reviewed: five unplanned and 14 planned, including the first case of an unplanned complex suicide in a woman. All cases were analyzed in terms of gender, age, methods of suicide, the presence of a suicide note, and past suicide attempts, and statistically compared with a 50-case sample of simple suicides. A further comparison was established with compiled data from the literature. Similarities were revealed regarding incidence of complex suicides, male gender predominance, and types of methods used. In contrast, results showed a higher average age for planned complex suicide victims. Finally, the authors discuss the application of the complex suicide definition.     

The Richard Cory phenomenon: suicide and wealth in Kansas City, Missouri

This case-control study investigates the relationship between suicide and wealth in Kansas City, Missouri. House and personal property appraisal data on all victims of suicide from 1998 and 2002 and victims from a control population of deaths reported to the Jackson County Medical Examiner during the same time interval were obtained from the Jackson County Government website. The controls were matched to suicide cases by race, gender, year of death, and age at death (+/- 1 year). Data from the 426 members of each group of suicides and controls indicate that suicide victims were: 1) 77% more likely than controls to have lived in houses rather than in apartments or trailers, 2) more likely than controls to have lived in more expensive houses (mean values dollar 70,143 versus dolllar 61,513 respectively, p = 0.04) and 3) more likely to have killed themselves because of factors other than financial strain (8.0% of suicides showed financial strain).