Psychiatric And Psychosocial Profile Of Suicidal Deaths: A Twelve-Year Retrospective Medico-Legal Study With A Psychological Autopsy Perspective.

Abstract

Background: Aim: To study the demographic and medico-legal profile of suicidal deaths over a twelve-year period and to interpret the observed pattern from a psychiatric and psychological-autopsy perspective. Materials and Methods: A retrospective observational study was conducted at a tertiary care centre in western Maharashtra, India, over twelve calendar years from 1 January 2009 to 31 December 2021. During the study period, 3144 medico-legal autopsies were performed, of which 397 suicidal deaths were identified. Cases with incomplete relevant history, unidentified bodies, skeletonised bodies, exhumed bodies and homicidal hanging were excluded. Information was obtained from autopsy reports, inquest papers, available history and forensic science laboratory reports. Demographic variables and methods of suicide were analysed using descriptive statistics. Available information was interpreted from a psychiatric and psychosocial perspective. No standardized psychological-autopsy interview was performed. Results: Of the 3144 medico-legal autopsies, 397 (12.62%) were suicidal deaths. The highest annual number was observed in 2016, with 62 (15.61%) cases. Hanging was the predominant method, accounting for 313 (78.84%) cases, followed by poisoning in 67 (16.87%) cases. Males constituted 248 (62.46%) cases and females 149 (37.53%), with a male-to-female ratio of 1.66:1. The 20–39-year age group accounted for the largest proportion of deaths, with 233 (58.69%) cases. Urban residents constituted 301 (75.81%) cases, while 91 (22.92%) were rural. The available dataset did not permit systematic quantification of previous psychiatric illness, previous suicidal behaviour, substance use or specific psychosocial stressors. Conclusion: Suicidal deaths constituted 12.62% of medico-legal autopsies during the study period, with a predominance among males and young adults and a marked predominance of hanging. The findings highlight important demographic groups for suicide-prevention interventions. Incorporation of standardized psychological-autopsy methodology and psychiatric assessment in future studies may help identify psychiatric morbidity, psychosocial stressors, previous suicidal behaviour and missed opportunities for intervention.