Retrospective study on suicidal cases by sharp force injuries

A total of 65 suicidal cases due to sharp force injuries (cut and/or stab wounds) were investigated. Suicide by sharp force injuries accounted for 2.5% of all suicides in our prefecture during 1995-2005. The 65 victims were composed of 49 males and 16 females, and the age range of 50-70 years was most common. A history of psychiatric disease was found in 11 victims, and depression was the most common disease followed by schizophrenia. Of 65 cases, 8 victims had a history of previously attempting suicide. In 41 cases, a suicide note or will was found. Forty-six cases had pleural sharp force injuries. Interestingly, the remaining 19 deaths were due to a single sharp injury. Cutting injuries were predominantly located at the flexor side of the wrist (11 cases, 38%), followed by the neck (10 cases, 34%). On the other hand, stab wounds were most commonly located in the chest (17 cases, 49%). Tentative wounds, which were superficial cut wounds or stab wounds, were present in 37 cases (57%). In 27 of 37, hesitation marks were observed in close proximity. Tentative wounds more frequently appeared in cut injuries than in stab injuries. Of 28 cases with fatal cut or stab wounds localized in the trunk, 11 cases (39%) had clothing damage. In the discrimination between suicide and homicide, forensic pathologists should obtain information on victims and witnesses as well as investigating the scene and postmortem examination of the victim.