Skip to main content

Advertisement

Log in

Unusual (self-)injuries in a case of hanging

  • Images in Forensics
  • Published:
Forensic Science, Medicine and Pathology Aims and scope Submit manuscript

Abstract

A 41-year-old man was found by his wife in an atypical hanging situation in their apartment. As there was a known previous psychiatric illness and a history of suicide attempts, the investigative authorities assumed this case was a suicide. However, the autopsy revealed numerous findings that are unusual for a suicidal atypical hanging, including numerous cuts on the face, the arms and the penis. According to his wife, the deceased suffered from Asperger's syndrome with auto-aggressive behavior. He had allegedly injured himself with household scissors in the days before his death and had hit himself numerous times in the face the night before his death. His wife also revealed that she would injure him with scissors at his request. Even though the observed injury pattern in this case contradicted a self-infliction, the information given by the wife about the chronology of the occurrence of injuries could be reconciled with the findings of the immunohistochemical estimation of wound age. The circumstances that led to the hanging remained unresolved.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Osuch E, Noll J, Putnam F. The motivation for self-injury in psychiatric inpatients. Psychiatry. 1999;62:334–6. https://doi.org/10.1080/00332747.1999.11024881.

    Article  CAS  PubMed  Google Scholar 

  2. Nitkowski D, Petermann F. Non-suicidal self-injury and comorbid mental disorders: a review. Fortschr Neurol Psychiat. 2011;79:9–20. https://doi.org/10.1055/s-0029-1245772.

    Article  CAS  PubMed  Google Scholar 

  3. Bohus M, Schmahl C. Psychopathology and treatment of borderline personality disorders. Nervenarzt. 2007;78:1069–81. https://doi.org/10.1007/s00115-007-2341-x.

    Article  CAS  PubMed  Google Scholar 

  4. Biskin R, Paris J. Diagnosing borderline personalitiy disorder. CMAJ. 2012;184:1789–94. https://doi.org/10.1503/cmaj.090618.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Pollak S. Verletzung durch eigene oder fremde Hand. In: Brinkmann B, Madea B, editors. Handbuch gerichtliche Medizin. Berlin, Heidelberg, New York, Tokio: Springer; 2004. p. 250–7.

  6. Petermann F, Winkel S. Selbstverletzendes verhalten. diagnostische und psychotherapeutische ansätze. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie. 2007;55:123–33. https://doi.org/10.1024/1661-4747.55.2.123.

    Article  Google Scholar 

  7. Fliege H, Kocalevent R, Walter O, Beck S, Gratz K, Gutierrez P, et al. Three assessment tools for deliberate self-harm and sucide behaviour: evaluation and psychopathological correlates. J Psychosom Res. 2006;61:113–21. https://doi.org/10.1016/j.jpsychores.2005.10.006.

    Article  PubMed  Google Scholar 

  8. Ishida Y, Kuninaka Y, Nosaka M, Shimada E, et al. Forensic application of epidermal AQP3 expression to determination of wound vitality in human compressed neck skin. Int J Leg Med. 2018;132:1375–80. https://doi.org/10.1007/s00414-018-1780-1.

    Article  Google Scholar 

  9. Kubo H, et al. Forensic diagnosis of ante- and postmortem burn based on aquaporin-3 gene expression in the skin. Leg Med. 2014;16:128–34. https://doi.org/10.1016/j.legalmed.2014.01.008.

    Article  CAS  Google Scholar 

  10. Madea B, Doberentz E, Jackowski C. Vital reactions – An updated overview. Forensic Sci Int. 2019;305:110029. https://doi.org/10.1016/j.forsciint.2019.110029.

    Article  CAS  PubMed  Google Scholar 

  11. Betz P. Histologische kriterien zur altersschätzung menschlicher hautwunden. Rechtsmed. 1999;9:163–9. https://doi.org/10.1007/s001940050103.

    Article  Google Scholar 

  12. Matsumoto T, Azekawa T, Yamaguchi A, Asami T, Iseki E. Habitual self-mutilitation in Japan. Psychiatry Clin Neurosci. 2004;58:191–8. https://doi.org/10.1111/j.14401819.2003.01216.x.

    Article  PubMed  Google Scholar 

  13. Matsumoto T, Yamaguchi A, Chiba Y, Asami T, Iseki E, Hirayasu Y. Patterns of self-cutting: A preliminary study on differences in clinical implications between wrist- and arm-cutting using a Japanese juvenile detention center sample. Psychiatry Clin Neurosci. 2004;58:377–82. https://doi.org/10.1111/j.1440-1819.2004.01271.x.

    Article  PubMed  Google Scholar 

  14. Töro K, Pollak S. Complex suicide versus complicated suicide. Forensic Sci Int. 2009;184:6–9. https://doi.org/10.1016/j.forsciint.2008.10.020.

    Article  PubMed  Google Scholar 

  15. Du Chesne A, Brinkmann B. Autoerotische unfälle. In: Brinkmann B, Madea B, editors. Handbuch gerichtliche Medizin, vol. 1. Berlin, Heidelberg, New York, Tokio: Springer; 2004. p. 794–6.

    Google Scholar 

  16. Briere J, Gil E. Self-mutilitation in clinical and general population samples: prevalence, correlates and functions. Am J Orthopsychiatry. 1998;68:609–20. https://doi.org/10.1037/h0080369.

    Article  CAS  PubMed  Google Scholar 

  17. Nixon MK, Cloutier PF, Aggarwal S. Affect regulation and addictive aspects of repetitive self-injury in hospitalized adolescents. J Am Acad Child Adolesc Psychiatry. 2002;41:1333–41. https://doi.org/10.1097/00004583-200211000-00015.

    Article  PubMed  Google Scholar 

  18. Klonski ED. The functions of deliberate self-injury: A review of the evidence. Clin Psychol Rev. 2007;27:226–39. https://doi.org/10.1016/j.cpr.2006.08.002.

    Article  Google Scholar 

  19. Paquette-Smith M, Weiss J, Lunsky Y. History of suicide attempts in adults with asperger syndrome. Crisis. 2014;35:273–7. https://doi.org/10.1027/0227-5910/a000263.

    Article  PubMed  Google Scholar 

  20. Takara K, Kondo T. Comorbid atypical autistic traits as a potential risk factor for suicide attempts among adult depressed patients: a case-control study. Ann Gen Psychiatry. 2014;13:33. https://doi.org/10.1186/s12991-014-0033-z.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Statistisches Bundesamt. http://www.gbe-bund.de/oowa921-install/servlet/oowa/aw92/dboowasys921.xwdevkit/xwd_init?gbe.isgbetol/xs_start_neu/&p_aid=i&p_aid=46319629&nummer=6&p_sprache=D&p_indsp=7062&p_aid=73792279. Accessed 21 Oct 2020.

  22. WHO. https://www.who.int/healthinfo/mortality_data/en/. Accessed 09 Apr 2020.

  23. Arsenault-Lapierre G, Kim C, Turecki G. Psychiatric diagnoses in 3275 suicides: a meta-analysis. BMC Psychiatry. 2004;4:37. https://doi.org/10.1186/1471-244X-4-37.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Asukai N. Suicide and mental disorders. Psychiatry Clin Neurosci. 1995;49:91–7. https://doi.org/10.1111/j.1440-1819.1995.tb01926.x.

    Article  Google Scholar 

  25. Byard RW. Suizidales erhängen mit anogenitalen mutilitationen Rechtsmed. 2012;22:187–9. https://doi.org/10.1007/s00194-012-0826-9.

    Article  Google Scholar 

  26. Austin AE, Guddat SS, Tsokos M, Gilbert JD, Byard RW. Multiple injuries in suicide simulating homicide: report of three cases. J Forensic Leg Med. 2013;20:601–4. https://doi.org/10.1016/j.jflm.2013.02.005.

    Article  PubMed  Google Scholar 

  27. Madea B. Homicidal versus suicidal penis amputation. A contribution to the problem of missing and conflicting stains. Arch Kriminol. 1995;196:70–7.

  28. Banaschack S, Madea B. Selbstbeschädigung. In: Madea B, editor. Praxis der Rechtsmedizin. Berlin, Heidelberg, New York: Springer; 2003. p. 268–73.

    Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Inga Duval.

Ethics declarations

Conflict of interest

The corresponding author declares also on behalf of her co-authors there is no conflict of interest.

Informed Consent

Consent to participate and consent for publication were not applicable.

Research involving human and animal participants

This article does not contain any studies with human participants or animals.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Duval, I., Doberentz, E. & Madea, B. Unusual (self-)injuries in a case of hanging. Forensic Sci Med Pathol 17, 354–361 (2021). https://doi.org/10.1007/s12024-020-00346-w

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12024-020-00346-w

Keywords

Navigation