Complex suicides: 21 cases and a review of the literature

Erdem Hösükler,Bilgin Hösükler,Sermet Koç,İsmail Çoban

doi:10.1186/s41935-022-00269-3

Abstract

BackgroundThe use of more than one potentially lethal method together and sequentially to complete suicide is called “complex suicide.” Complex suicides are divided into two groups: planned and unplanned. This study aimed to discuss with literature 21 complex suicide cases identified after a 2-year retrospective study.ResultsThis study included 21 complex suicide cases. Eleven were classified as planned complex suicides, and 10 were labeled as unplanned complex suicides. The average age of all cases was 42.5 ± 17.7 (min: 19, max: 76) years. Suicide notes were present in six (28.5%) cases. Fifteen victims (71.4%) suffered from psychiatric diseases. Twelve victims ingested a toxic dose of medication, nine cases jumped from a height, eight cases used stabbing, six cases used hanging, two cases ingested a corrosive substance, two cases drowned, two cases inhaled a toxic gas, one case ingested cyanide, one case ingested insecticide, and one case used suffocation with a plastic bag. In two cases, three methods of suicide were used together. In the current study, “corrosive substance intake + cyanide intoxication” and “corrosive substance intake + jumping from a height” were defined for the first time and have not been previously described in the literature.ConclusionsComplex suicides are highly likely to be potentially mistaken for murder. The cause of death in these cases can be determined with a comprehensive autopsy along with a detailed examination of the scene, statements of relatives, and eyewitnesses.

Highlights

The use of more than one potentially lethal method together and sequentially to complete suicide is called “complex suicide.” Complex suicides are divided into two groups: planned and unplanned
Gender and age In this study, 21 (2.2%) cases of complex suicide were detected from 937 suicide cases
Eleven (52.3%) cases were classified as planned complex suicides, while 10 (47.7%) cases were unplanned complex suicides

Summary

Introduction

The use of more than one potentially lethal method together and sequentially to complete suicide is called “complex suicide.” Complex suicides are divided into two groups: planned and unplanned. The use of more than one potentially lethal method together and sequentially to complete suicide is called a “complex suicide” (Christin et al 2018; Demirci et al 2009; Kučerová Š et al 2019; Simonit et al 2018). Most studies on complex suicides in the literature are case reports (Akçan et al 2016; Ateriya et al 2018; Bogdanović et al 2019; Cascini et al 2012; Christin et al 2018; Dogan et al 2014; Germerott et al 2010; Kučerová et al, 2019; Pélissier-Alicot et al 2008; Petković et al 2011; Simonit et al 2018; Straka and Novomesky 2013; Vadsinghe and Thilakarathne 2018; Vidhate et al 2016) and few systematic studies currently exist available This study aimed to discuss the characteristics of 21 complex suicide cases detected after a 2-year retrospective study with literature

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