A suicide pact is the decision of two or more people to die together. This event is rare. The majority of suicide pacts victims are married, socially isolated, with a serious physical illness in one or both partners. We performed a retrospective study of all cases of suicide pacts leading to death between January 1, 2003 and December 31, 2010 referred to the Forensic Medicine Department of Tours (France). Six cases were recorded as suicide pacts. Firearms were the preferred means of death. Five suicide notes were discovered. For some cases, it was difficult to establish whether death was the result of a suicide pact or of a homicide-suicide without the consent of the victim. An objective element, such as a suicide note and motive, is required to prove that a suicide pact is involved. The prevalence of mental disorders is hard to assess. In France, psychological autopsies are not performed in such cases, as the investigation is usually very sparse after the death of both individuals.

This review aims to consolidate the available information on use of electroretinography as a diagnostic tool in psychiatry. The electroretinogram (ERG) has been found to have diagnostic utility in cocaine withdrawal (reduced light-adapted b-wave response), major depressive disorder (reduced contrast gain in pattern ERG), and schizophrenia (reduced a- and b-wave amplitudes). This review examines these findings as well as the applicability of ERG to substance use disorder, Alzheimer’s disease, autism spectrum disorder, panic disorder, eating disorders, attention deficit hyperactivity disorder, and medication use. While there have been promising results, current research suffers from a lack of specificity. Further research that quantifies anomalies in ERG present in psychiatric illness is needed.

Penetrating stab wounds of the brain are uncommonly seen in modern times and occur almost exclusively in homicides. We report an unusual death by self-stabbing. A 24-year-old man was found dead at home, the handle of a kitchen knife protruding from his forehead. Data such as the psychiatric history of the victim, the multiplicity and site of wounds, the implement used, the presence of hesitation, and defense wounds were studied to elucidate the manner of death, and the suicidal nature of the event was established after police investigation. Atypical injuries require a careful forensic investigation, and medico-legal aspects of the differentiation between homicide and suicide are discussed in this particular case. A review of the literature revealed few cases of suicidal transcranial stab wounds.