{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:14:20Z","timestamp":1777896860120,"version":"3.51.4"},"reference-count":48,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Med Sci Law"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Complex Suicide<\/jats:italic>\n                    (CS) is defined as an unusual form of suicide in which several harmful methods are used, simultaneously or in succession, whose purpose is to avoid the possible ineffectiveness of one of the methods used to produce a certain fatal outcome. The study of CS is of great interest and plays a fundamental role in characterizing the knowledge of these rare events. We have retrospectively evaluated all CS cases examined at the Institute of Forensic Medicine of Milan from 1993 to 2022 (n\u2009=\u200975) with the aim of characterizing the deceased who have resorted to it. We also compared the sample of 75 CS cases with a sample of paired 115 \u201csimple\u201d suicides (with a single method). Our analysis revealed that the CS cases were carried out by a \u201ctypical\u201d subject identified as an adult male, between 41 and 50 years old, suffering from psychiatric disorders and, in particular, major depressive disorder. The most frequent harmful mode was plastic bag suffocation associated with self-poisoning. CS cases used less violent methods than simple suicide controls. The pathological-forensic approach has brought to light elements that can be useful both for forensic professionals (pathologists and psychiatrists) in correctly classifying these unusual and challenging events and for clinicians working on the front line. Some profiles have been outlined that can be used to identify potentially vulnerable individuals who could benefit from increased health surveillance to treat and prevent suicide.\n                  <\/jats:p>","DOI":"10.1177\/00258024251319694","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T03:36:43Z","timestamp":1740109003000},"page":"6-17","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Forensic and psychopathological framing of complex suicides: A retrospective study over the last 30 years"],"prefix":"10.1177","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-5545","authenticated-orcid":false,"given":"Stefano","family":"Tambuzzi","sequence":"first","affiliation":[{"name":"Universit\u00e0 degli Studi di Milano"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4407-9844","authenticated-orcid":false,"given":"Guendalina","family":"Gentile","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Milano"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4240-4121","authenticated-orcid":false,"given":"Michele","family":"Boracchi","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Milano"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9102-9209","authenticated-orcid":false,"given":"Franca","family":"Crippa","sequence":"additional","affiliation":[{"name":"University of Milan-Bicocca"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8130-437X","authenticated-orcid":false,"given":"Raffaella","family":"Calati","sequence":"additional","affiliation":[{"name":"University of Milan-Bicocca"},{"name":"Department of Adult Psychiatry, Nimes University Hospital, Nimes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3347-2541","authenticated-orcid":false,"given":"Riccardo","family":"Zoja","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Milano"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,2,21]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/PAF.0b013e318187deb7"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1556-4029.2010.01507.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/PAF.0000000000000503"},{"key":"e_1_3_2_5_2","first-page":"138","article-title":"Complex suicides-a review of the literature","volume":"213","author":"Bohnert M","year":"2004","unstructured":"Bohnert M, Pollak S. 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