Complex and complicated suicides in Friuli (1993-2017)

Area of Science:

• Forensic Pathology
• Toxicology
• Psychiatry

Background:

• Complex suicides involve multiple suicide methods, classified as planned or unplanned based on victim intent.
• Complicated suicide, a distinct fatal outcome following a failed suicide attempt with subsequent traumatization, requires differentiation.
• Understanding these distinct categories is crucial for accurate death investigation and forensic analysis.

Purpose of the Study:

• To differentiate between complex and complicated suicides.
• To analyze the characteristics of complex suicides, including planned versus unplanned methods.
• To report the incidence and methods used in complex and complicated suicides within a defined population.

Main Methods:

• Retrospective analysis of 1160 fatalities between 1993 and 2017.
• Identification and classification of complex and complicated suicide cases.
• Examination of demographic data, psychiatric history, previous attempts, and suicide methods.

Main Results:

• Identified 20 cases (1.72%) of complex suicide and 3 cases (0.26%) of complicated suicide.
• Complex suicides were predominantly planned (16 vs. 4), involved males (17), and adults (median age 48).
• Common methods included plastic bag suffocation and gas inhalation (8); firearms were used exclusively by males in planned complex suicides.

Conclusions:

• Complex suicides are more prevalent than complicated suicides and typically involve planned multi-method approaches.
• Distinct characteristics, including methods and victim demographics, differentiate complex and complicated suicides.
• Further research into the specific mechanisms and psychological factors underlying complex suicides is warranted.