In October 2016, the Public Security Bureau received a report that someone in a rental house in the jurisdiction had committed suicide by burning charcoal.
When the forensic doctor arrived, the scene had been cordoned off, it was a simple one-room and one-room suite, the doors and windows were locked, and the police violently broke the door before entering the scene.
There is nothing abnormal in the living room, but as soon as you push open the bedroom door, you can see that there is a charcoal basin in the middle of the bedroom, the charcoal inside has been basically burned out, and the inside of the door is glued with scotch tape that seals the door gap.
On the double bed lay three of the 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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After an initial autopsy, it was found that all three had died of carbon monoxide poisoning, had taken sleeping pills, and that the mother had drunk a lot of alcohol during her lifetime.
The scene survey supported the autopsy.
In the drawer we found unfinished sertraline, venlafaxine (all common antidepressant psychotropics), a small bottle of clonazepam, and the outpatient medical records of the 33-year-old deceased, with the diagnosis written impressively: depression.
In the process of investigating the scene, what is even more touching is a four-page suicide note left by the young mother before her death.
It says about the mother's experiences from childhood to adulthood: when she was a child, her parents divorced, she was bullied in middle school, she dropped out of school, she had depression, she had several failed love lives as adults, and then she married someone and had two children.
From the beginning of 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, but more often, she was suffering in pain.
I thought that love and marriage would get her out of the pain of her original family, but the reality was that in the eight-year-long marriage, she could not truly live in harmony with her husband and in-laws, and life was not smooth everywhere, and long-term medication only allowed her to maintain her work and life slightly normally.
In the more than two years after the divorce, she became more and more financially embarrassed, constantly had various chores that consumed her only energy, and conventional antidepressants eventually failed to help her resist the invasion of the disease.
In the end, she chose to commit suicide and took two children with her.
The suicide note read: "After I am gone, they will have no one to take care of, so it is better to go together, and they will not have to suffer." ”
Doors and windows were blocked, charcoal basins and charcoal were prepared, children were tricked into taking sleeping pills, and after drinking alcohol, the charcoal basins were lit, and the lives of the three people ended.
After understanding this case, perhaps many people have doubts, "tiger poison does not eat children", why did this woman commit suicide and take a child?
In many people's minds, depression is the worst outcome of suicide. But in fact, if depression is not treated in time, it may not only lead to its own tragedy, but also sometimes expand sexual suicide behavior, endangering the family, and even the more "loved" people are more dangerous.
The so-called extended suicide is an act dominated by pathological emotions. Manifested as killing and suicide occur one after another, and the purpose of killing is out of "pity" for the victim, worried that in the future these relatives will suffer from the world, it is better to kill the relatives first, then die themselves, exempt from worries, the motive seems to be good, so it is also called "compassion killing", the killing objects are the patient's favorite wife, children, the elderly, young and weak family members, so it is also called "family suicide", especially young women patients "baby killing" cases are more common [2].
In addition to "altruistic suicide" in order to consider that their relatives may suffer misfortune after death, there are also people with depression who, for the sake of certain benefits of themselves, children or families, do not hesitate to kill their relatives before committing suicide, showing "self-interested suicide" [3].
According to incomplete statistics, in the 2010-2020 decade of the author's jurisdiction, a total of 12 cases of extended suicide occurred, with a cumulative death toll of 28. Among them, there were 5 cases of male patients and 7 cases of female patients.
In these cases of enlarged suicide, some common features can be observed:
1. Before suicide, there are typical mood depressions, and some of the killers have a clear history of depression.
2. Suicide and homicide are premeditated, the success rate is extremely high, and there are different degrees of arrangements for posthumous events.
3. The targets of killing are their own relatives, most of the men are spouses or young children, and most of the women are young children.
4. Before and during the murder, the murderer and the victim did not have common homicide triggers such as fierce quarrels and contradictions and disputes.
5. Homicide and suicide often occur simultaneously or sequentially.
6. Most of the places of occurrence are at home or nearby, and there is basically no camouflage and vandalism at the scene of the killing.
"I'm depressed." It can be regarded as an Internet buzzword. Everyone has times when they are depressed, so what is the difference between depression and real depression?
Depression is a clinical type of affective mental disorder (or mood disorder). It is characterized by a significant and persistent depression.
Among all mental disorders, the suicide rate of depressed patients is the highest, which is a disease with high recurrence rate, high disability rate and high suicide rate that seriously endangers human physical and mental health. 25% of people with depression develop suicide or suicide attempts at the onset of illness [1].
Typical depressive symptoms "three lows" are manifested as: persistent low mood, slow thinking, and decreased will activity.
One measure of the severity of depression is to see if the depressive state directly affects the patient's work, study, and quality of life.
In fact, whether we are depressed or not, we can also try some self-assessment scales first: for example, the 90 symptom list SCL-90 (Symptom Checklist 90). However, no matter how good the self-assessment scale of credibility and validity, it is only used for auxiliary diagnosis, and the face-to-face diagnosis and follow-up diagnosis of professional doctors can give you a more reasonable judgment.
When you or your family members and friends have symptoms of depression, you should try to actively persuade them to seek medical treatment and seek professional medical advice.
Due to the long course of depression, it is often necessary to take drugs for a long time, so family members should learn drug management, urge patients to take drugs on time and in quantity, and pay attention to supervising the taking of drugs to the mouth, prevent patients from hiding drugs, so as not to affect the treatment effect, and also eliminate drug abuse.
Family members try to master some common drug poisoning knowledge, as well as some common traumatic first aid measures, and have the ability to take certain rescue measures in the event of poisoning and other accidental injuries [4].
In addition, encourage them to engage in aerobic exercise, 3-5 times a week, 20-60 minutes of aerobic exercise, such as running, cycling, dancing, etc. can effectively help alleviate depression and reduce drug side effects [5].
In life, we should pay close attention to them as much as possible, increase their sense of security, create a good safety environment, listen patiently and attentively to the patient's talk, and increase the patient's self-confidence. Actively help patients rebuild social support systems and improve their health [6].
Review Expert: Hu Qiang | Doctoral student and attending physician of Shanghai Mental Health Center
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Xue Liyan,Xu Shenghan. Expanded suicide seen in forensic evaluation (with 7 cases analysis)[J].Journal of Forensic Science, 1992(04):172-174.
Wang Zhiliang,Fan Qiang. Expanded suicide and self-interested suicide in depression[J].Chinese Journal of Psychiatry,2012(03):175-176.
Wang Xiaoyan,Gao Haihong,Zhang Limei. A Brief Discussion on Community Home Treatment and Nursing care for patients with depression[J].Chinese Medical Guidelines,2012,10(34):318-319.
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. Correlation between suicide risk and the number and degree of depression in depressed patients[J].Chongqing Medicine,2016,45(13):1810-1812.
*The content of this article is a popularization of health knowledge and cannot be used as a specific diagnosis and treatment recommendation, nor is it a substitute for face-to-face consultation by a practicing physician, for reference only.
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