Banchini Antonio, Schirripa Maria Laura, Anzillotti Luca, Cecchi Rossana
Institute of Legal Medicine, University of Parma, Via A. Gramsci 14, Parma, Italy.
Institute of Legal Medicine, University of Parma, Via A. Gramsci 14, Parma, Italy.
Leg Med (Tokyo). 2017 Nov;29:62-67. doi: 10.1016/j.legalmed.2017.10.005. Epub 2017 Oct 13.
Complex suicide is performed using more harmful methods, simultaneously or consecutively. In these cases, the distinction between suicide and homicide represents a challenge for forensic pathologists. In literature, complex suicide is divided in two subgroups: "planned complex suicide" or "unplanned complex suicide" depending from forensic features and often related to psychiatric variables. Aim of this study was to show the casuistry of complex suicide in Parma's Forensic service analyzing, for each case, the forensic medical problems (type and site of lesions on the body), and the supplementary data [Police's inspection report, toxicological analysis and psychiatric anamnesis (when available)], trying, through a multidisciplinary approach, to determine a possible correlation between the victim's mood and suicide's method chosen, whether planned or unplanned. Our results showed the importance of all the elements collected on the crime scene to distinguish suicide from homicide, and the correlation between bipolar disorder, borderline personality disorder and schizophrenia with unplanned complex suicide (because of the impulsiveness), and major depression disorder and anxiety disorder with planned complex suicide. Being able to understand the causes behind this extreme gesture may become important not only for forensic pathologists and judicial authority, but also, and above all, for the family as well.
复杂自杀是指使用更具伤害性的方法，同时或相继实施的自杀行为。在这些案例中，区分自杀和他杀对法医病理学家来说是一项挑战。在文献中，复杂自杀根据法医特征分为两个亚组：“计划性复杂自杀”或“非计划性复杂自杀”，且通常与精神科变量相关。本研究的目的是通过分析帕尔马法医服务中心的复杂自杀案例集，针对每个案例剖析法医问题（身体上损伤的类型和部位）以及补充数据[警方检查报告、毒理学分析和精神科病史（如有）]，尝试通过多学科方法确定受害者的情绪与所选择的自杀方式（无论是计划性还是非计划性）之间可能存在的关联。我们的结果表明，在犯罪现场收集的所有元素对于区分自杀和他杀具有重要意义，并且双相情感障碍、边缘型人格障碍和精神分裂症与非计划性复杂自杀（因其冲动性）之间存在关联，而重度抑郁症和焦虑症与计划性复杂自杀之间存在关联。能够理解这种极端行为背后的原因不仅对法医病理学家和司法当局很重要，而且首先对受害者家属也很重要。
