抑郁症患者自杀死亡的法医学分析

Forensic Analysis of Suicide in Depressed Patients

目的总结分析抑郁症患者自杀的一般特点,法医现场勘验中的鉴别要点和注意事项。方法收集长宁区2009-2013年受理的抑郁症患者的自杀案例28例进行分析。结果在所收集抑郁症患者自杀28起案例中,女性比例较男性高;自杀者年龄集中于40～60岁及70～80岁两个年龄段,呈双峰分布;28起案例中有先发症状（留有遗书、厌世倾向）的有21例;大部分自杀者自杀地点位于家中;自杀方式多为自缢及高坠等剧烈方式;病程普遍较长,多为10年以上;5名死者自杀前遭遇明显心理应激事件。结论先发症状、长病程、明显心理应激事件是抑郁症患者自杀死亡的明显特点,自缢、高坠及服药等自杀方式以及留有遗书的现场可作为法医现场勘验中的注意要点。

Objective To analyze and summarize the general characteristics of suicide cases in the depressed patients as well as the corresponding key points and cautions in forensic scene investigation. Methods Twenty eight suicide cases among patients with depression from 2009 to 2013 in Changning district of Shanghai were analyzed. Results In the collected cases, the proportion of women is higher than than of men. The age was concentrated in the range of 40-60 and 70-80. There were omens（suicide notes or misanthropic tendencies） before death in twenty one cases. Most patients committed suicide at home. The dead often adopted hanging or jumping from high to end their life. Those patients generally had a more than 10 years medical history. Five deceased suffered significant mental stress events before death. Conclusion Omens, long medical history and mental stress events are distinctive features of suicide in depressed patients. Hanging, high falling and medication, and existence of suicide note are the key points during forensic scene investigation.