Observations on self-incineration characteristics in 24 years (1993–2016) of autopsies in the city of Milan

Abstract

Self-incineration is one of the most dramatic and lethal suicide methods. It is rarely reported in Western countries and is more frequent in developing regions. We illustrate the forensic cases of self-immolation occurring over 24 years in the city of Milan, Italy, highlighting the main issues of such a complex and rare suicide. We selected 33 cases of self-incineration among 23,417 autopsies (4022 suicides) performed at the Department of Legal Medicine of the University of Milan over a period of 24 years (1993-2016). Several parameters were included and analysed: gender and age of the victims, pathological history, previous suicide intentions/attempts, duration of burning, place of death or discovery of the corpse, circumstantial data of fatal events and autopsy findings, with particular attention to thermal injuries. Self-incineration was found in 0.8% of total suicides and 0.14% of total autopsies. One of these cases involved a complex modality (association with plastic-bag suffocation). The typical characteristics of the victim were an Italian man with psychiatric illness, frequently moved by passion, existential discomfort and economic problems. During the 24-year period, the number of cases of self-incineration progressively reduced. This study provides a general overview in one of the biggest metropolitan Italian areas and is one of the few works performed on this topic. It may be helpful in understanding and studying such an unusual manner of suicide.

Self‐immolation Suicide in Greece: A Forensic Psychiatric Autopsy Study between 2011 and 2019

“…Regarding male:female gender ratio, a slight male predominance was observed among fatalities although not statistically significant due to the limited number of examined cases ( p > 0.10) leading to the conclusion of a rather random distribution between the sexes: (males) 58%–(females) 42%. The results of literature studies examining self‐immolation cases in developed countries (Switzerland, Germany, UK, Denmark, Italy, France, USA, Canada, and Turkey) are also in agreement with these findings formulating gender rates as follows: almost (males) 62%–(females) 38% (12,23,32,33,40,41), but indicate a statistically significant clear male preponderance ( p < 0.00001). The aforementioned study by Tsati et al .…”

“…It is noteworthy that the above studies concern burn center patients (suicide attempters), a proportion of whom passed away. The mean age of the victims of completed suicide with self‐immolation (autopsy cases) seems to be higher (almost one decade) as shown in studies from Italy and Switzerland (32,33). This is probably due to the increased mortality of burn patients with age (34,35).…”

“…In the present study on a Greek population sample, in 5 out of 19 cases (26%) the victim had a history of previous suicide attempt, but in the vast majority (74%) of the cases, there were no formerly enacted suicide attempts ( p ‐value < 0.01). On the contrary, studies from Italy (32), Switzerland (33), Germany (40), France (41), and the United States (51) on completed suicides by self‐immolation found the rate of previous suicide attempts to range between 34.5% and 93.2%. Aforementioned data indicate that past history of suicide attempts is a weak predictor of suicidal ideation that may be active at a given time.…”

“…Several studies have indicated that suicide victims usually prefer isolated places to engage in the act of suicide in privacy (32,41,44), probably because of their reluctance to be prevented or witnessed by others. On the contrary, it has been observed that when suicide by self‐immolation takes place as a symbolic response to the feeling of injustice, the act is more likely to occur in public places, usually in front of a crowd (45).…”

Technical note: Preparation improvement of charred cadaveric viscera using sandison’s rehydrating solution for histological analysis

“…Autopsy examination on these cadavers is arduous under several aspects, such as for personal identification, for chronological determination of the lesions observedin order to collocate them ante-or postmortem-, for stating the dynamic of the events in order to discriminate between accident, suicide [4] homicide/ cadaver's destruction [5] and, finally, for identifying the type of propellant used as a primer [2].…”