In October 2016, the Public Security Bureau received a report that someone committed suicide by burning charcoal in a rental house in the jurisdiction.
When the forensic doctor arrived, the scene had been cordoned off. It was a simple one-bedroom, one-bedroom suite. The doors and windows were locked, and the police broke the door violently to enter the scene.
There is no abnormality in the living room, but as soon as you open the bedroom door, you can see a charcoal basin in the middle of the bedroom. scotch tape.
On the double bed lay three dead, a 33-year-old mother and her two children, an 8-year-old daughter and a 5-year-old son.
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A preliminary autopsy found that all three died of carbon monoxide poisoning, in addition to taking sleeping pills, and the mother drank a lot of alcohol.
A site visit supports the autopsy situation.
In the drawer we found unfinished amounts of sertraline, venlafaxine (both common antidepressants), a vial of clonazepam, and the deceased 33-year-old ‘s outpatient medical records, the diagnosis is written: depression.
In the process of investigating the scene, what was even more touching was a four-page suicide note left by the young mother before her death.
It is written on the mother’s experience from childhood to adulthood: parents divorced as a child, bullied in middle school, dropped out of school, depression, several failed love lives in adulthood, and then married someone , have two children.
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From her teenage years to the end of her life at the age of 33, depression never really left her. Although it improved from time to time, she was suffering in pain more often. .
Thinking that love and marriage will free her from the pain of her original family, but the reality is that in the eight-year marriage, she cannot truly live in harmony with her husband and in-laws, and her life is full of unhappiness. , long-term medication only allows her to maintain her work and life somewhat normally.
In the more than two years after the divorce, she became increasingly embarrassed financially, with all kinds of trivial matters consuming her only energy, and conventional antidepressants eventually failed to help her resist Live the attack of the disease.
She ultimately committed suicide, with two children.
The suicide note reads: “After I leave, they will have no one to take care of them. Let’s go together, and they will not have to suffer.”
Blocked the doors and windows, prepared charcoal basins and charcoal, tricked the children into taking sleeping pills, lit the charcoal basin after drinking, and the lives of three people ended like this.
After learning about this case, many people may have doubts, “Tiger poison does not eat children”, why did this woman commit suicide and take children with her?
In many people’s minds, the worst outcome of depression is suicide. But in fact, if depression is not treated in time, it may not only lead to its own tragedy, but also sometimes expand suicide behavior, endangering family members, and even the more “loved” people are, the more dangerous it is.
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The so-called extended suicide is a behavior under the control of pathological emotions. It is manifested as murders and suicides happening one after another, and the purpose of the murders is out of “compassion” for the victims. Worrying that these relatives will suffer in the world in the future, it is better to kill their relatives first, and then die by themselves, so as to avoid worries. The motive seems to be kind. It is called “compassionate homicide”, and the targets of killing are the patients’ favorite wives, children, the elderly, young and weak family members, so it is also called “familial suicide”, among which cases of “infanticide” are more common among young women and patients [2] ].
Extended suicide In addition to “altruistic suicide” due to the consideration that relatives may suffer misfortune after their death, there are also patients with depression who, for the benefit of themselves, their children or their families, He did not hesitate to kill relatives before committing suicide, showing “selfish suicide” [3].
According to incomplete statistics, during the decade 2010-2020 in the author’s jurisdiction, there were 12 cases of extended suicide, with a cumulative death toll of 28. Among them, 5 were male patients and 7 were female patients.
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Through these extended suicide cases, some common features can be observed:
1. Before committing suicide, there was a typical depression, and some of the murderers had a clear history of depression.
2. Both suicides and murders are premeditated, with a very high success rate, and there are varying degrees of arrangements for the aftermath.
3. The murdered targets are all their own relatives, males are mostly spouses or young children, and females are mostly young children.
4. Before the murder and at the time of the murder, the murderer and the victim did not have common murder-inducing factors such as fierce quarrels and disputes.
5. Homicide and suicide often occur simultaneously or in succession.
6. The crime scene is mostly at home or nearby, and there is basically no disguise or vandalism at the murder scene.
“I’m depressed.” It’s an internet buzzword. Everyone has moments of depression, what’s the difference between a depression and a real depression?
Depression is a clinical type of affective disorder (or mood disorder). It is characterized by marked and persistent depression.
Depression has the highest suicide rate among all mental disorders. It is a disease with high recurrence rate, high disability rate, and high suicide rate that seriously endangers human physical and mental health. . Suicide or suicide attempt occurs in 25 percent of depressed patients [1].
Typical depressive symptoms “three lows”, manifested as persistently depressed mood, slow thinking, and decreased volitional activity.
A standard to measure the severity of depression is to see whether this depression directly affects the patient’s work, study, and quality of life.
Whether it is actually depression, we can also try some self-assessment scales: such as the 90-item symptom list SCL-90 (Symptom Checklist 90). However, no matter how reliable and valid the self-assessment scale is, it is only used for auxiliary diagnosis, and professional doctor’s face-to-face consultation and follow-up consultation can give you a more reasonable judgment.
When you or your family or friends show signs of depression, you should try your best to actively persuade you to seek medical advice and seek professional medical advice.
Due to the long course of depression, long-term medication is often required. Therefore, family members should learn medication management, urge patients to take medication on time and according to the amount, and pay attention to supervise taking medication to the mouth to prevent patients from hiding drugs. So as not to affect the treatment effect, but also to prevent drug abuse.
Families try to master some common drug poisoning knowledge and some common traumatic first aid measures, and have the ability to take certain treatment measures in the event of poisoning and other accidental injuries [4].
In addition, encourage them to do aerobic exercise, 3-5 times a week, 20-60 minutes of aerobic exercise each time, such as running, cycling, dancing, etc. can effectively help relieve depression , reduce the side effects of drugs [5].
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In life, pay close attention to them as much as possible, increase their sense of security, create a good safety environment, listen to patients’ complaints patiently and attentively, and increase patients’ self-confidence. Actively help patients rebuild their social support system and improve their health status [6].
Reviewing Expert: Hu Qiang| Doctoral Student, Attending Physician, Shanghai Mental Health Center
References
[1] Hao Wei, Yu Xin, Xu Yi. Psychiatry [M]. 6th Edition. People’s Health Publishing House. 2008
[2] Xue Liyan, Xu Shenghan. Expanded suicide seen in forensic identification (with an analysis of 7 cases) [J]. Journal of Forensic Medicine, 1992(04):172-174.
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[3] Wang Zhiliang, Fan Qiang. Extended suicide and egoistic suicide in depression[J]. Chinese Journal of Psychiatry, 2012(03):175-176.
[4] Wang Xiaoyan, Gao Haihong, Zhang Limei. Talking about community home treatment and nursing of patients with depression[J]. Chinese Medicine Guide, 2012, 10(34): 318-319.
[5] Ma Kun, Liu Jinmei, Fu Cuiyuan, Zhang Hu, Jia Shaohui. Research progress on the intervention effect and mechanism of exercise on depression [J]. China Sports Science and Technology, 2020, 56( 11):13-24.
[6] Qin Biyong, Dai Lilei, Wang Jian, Deng Xiaoling, Zheng Yan. Study on the correlation between suicide risk, number of comorbidities and degree of depression in patients with depression [J]. Chongqing Medical Science, 2016, 45 (13):1810-1812.
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