A Descriptive Cohort of Suicidal Cancer Patients: Analysis of the Autopsy Case Series from 1993 to 2019 in Milan (Italy)
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Socio-Demographic Features
3.2. Cancer-Related Features
3.3. Clinical Features
3.4. Suicide-Related Features
4. Discussion
5. Conclusions
Limitations
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Body Area | Site | Total (%) | Sex | |
---|---|---|---|---|
M (%) | F (%) | |||
Head 14 (4.9%) | Brain | 9 (64.3) | 5 (55.5) | 4 (44.5) |
Ear | 1 (7.1) | 1 (100) | ||
Tongue | 4 (28.6) | 3 (75) | 1 (25) | |
Neck 23 (8%) | Pharynx | 2 (8.8) | 2 (100) | |
Thyroid | 6 (26) | 2 (33.3) | 4 (66.7) | |
Larynx | 15 (65.2) | 14 (93.3) | 1 (6.7) | |
Chest 73 (25.3%) | Esophagus | 4 (5.5) | 4 (100) | |
Breast | 29 (39.7) | 29 (100) | ||
Lung | 40 (54.8) | 36 (90) | 4 (10) | |
Abdomen 78 (27.1%) | Liver | 11 (14.1) | 7 (63.6) | 4 (36.4) |
Biliary tract | 4 (5.1) | 4 (100) | ||
Pancreas | 13 (16.7) | 10 (77) | 3 (33) | |
Stomach | 12 (15.3) | 11 (91.6) | 1 (8.4) | |
Duodenum | 1 (1.4) | 1 (100) | ||
Colon | 26 (33.3) | 16 (61.5) | 10 (38.4) | |
Rectum | 9 (11.6) | 6 (66.6) | 3 (33.4) | |
Peritoneum | 2 (2.5) | 2 (100) | ||
Reproductive system 56 (19.4%) | Testicle | 5 (8.9) | 5 (100) | |
Prostate | 36 (64.3) | 36 (100) | ||
Ovary | 3 (5.3) | 3 (100) | ||
Uterus | 12 (21.5) | 12 (100) | ||
Urinary system 22 (7.7%) | Kidney | 10 (45.5) | 7 (70) | 3 (30) |
Bladder | 12 (54.5) | 11 (91.6) | 1 (8.4) | |
Immune system 16 (5.5%) | Lymphocytes | 16 (100) | 12 (75) | 4 (25) |
Integumentary system 5 (1.7%) | Skin | 5 (100) | 5 (100) | |
Skeletal system 1 (0.3%) | Bone | 1 (100) | 1 (100) |
Type of Pathology | Disease 1 | Disease 2 | N of Cases | % | |
---|---|---|---|---|---|
Single disease—139 | Psychiatric 111 (79.8%) | Depression | 109 | 98.1 | |
Psychosis | 2 | 1.9 | |||
Organic 28 (20.2%) | Hypertension | 9 | 32.1 | ||
Myocardial infarction | 8 | 28.5 | |||
Coronary artery disease | 2 | 7.2 | |||
Diabetes | 7 | 25 | |||
Hepatitis c virus (HCV) | 2 | 7.2 | |||
Multiple diseases—46 | Psychiatric 37 (80.4%) | Depression 37 (100%) | Alcoholism | 8 | 21.7 |
HCV | 4 | 10.8 | |||
Myocardial infarction | 4 | 10.8 | |||
Hypertension | 4 | 10.8 | |||
Diabetes | 3 | 8.1 | |||
Arrhythmia | 3 | 8.1 | |||
Bronchial asthma | 2 | 5.4 | |||
Kidney failure | 2 | 5.4 | |||
Maculopathy | 2 | 5.4 | |||
Epilepsy | 1 | 2.7 | |||
Cerebral stroke | 1 | 2.7 | |||
Parkinson disease | 1 | 2.7 | |||
Pulmonary emphysema | 1 | 2.7 | |||
Sarcoidosis | 1 | 2.7 | |||
Organic 9 (19.6) | COPD (chronic obstructive pulmonary disease) 4 (44.4%) | Hypertension | 2 | 50 | |
HCV | 1 | 25 | |||
Heart failure | 1 | 25 | |||
Hypertension 5 (55.6) | Aortic aneurysm | 1 | 20 | ||
Diabetes | 1 | 20 | |||
Epilepsy | 1 | 20 | |||
Glaucoma | 1 | 20 | |||
Neuropathy | 1 | 20 |
(A) | |||
Medication | N of Cases (%) | ||
Single-drug therapy—133–66% | Chemotherapy | 44 (33) | |
Antidepressants | 38 (28.7) | ||
Anxiolytics | 12 (9) | ||
Antihypertensive | 5 (3.8) | ||
Analgesic | 8 (6) | ||
Antiepileptic | 2 (1.5) | ||
Oxygen therapy | 1 (0.7) | ||
Antipsychotics | 4 (3) | ||
Proton-pump inhibitor | 2 (1.5) | ||
Antithyroid | 3 (2.3) | ||
Antiparkinsonian | 1 (0.7) | ||
Antiplatelets agents | 3 (2.3) | ||
Oral hypoglycemic agents | 3 (2.3) | ||
Anti-inflammatory | 4 (3) | ||
Diuretics | 2 (1.5) | ||
Blood products | 1 (0.7) | ||
(B) | |||
Medication | N of Cases (%) | ||
Multi-drug therapy—68–34% | Antidepressants 29 (42.7%) | Chemotherapy | 6 (20.6) |
Anxiolytics | 13 (44.8) | ||
Antihypertensive | 4 (13.8) | ||
Morphine | 3 (10.3) | ||
Immunosuppressants | 1 (3.5) | ||
Antiarrhythmic | 1 (3.5) | ||
Antiepileptic | 1 (3.5) | ||
Chemotherapy 18 (26.5%) | Morphine | 5 (27.7) | |
Antihypertensive | 4 (22.2) | ||
Insulin | 2 (11.2) | ||
Cortisone | 2 (11.2) | ||
Diuretics | 1 (5.5) | ||
Antiemetics | 2 (11.2) | ||
Interferon | 1 (5.5) | ||
Oral hypoglycemic agents | 1 (5.5) | ||
Analgesic 8 (11.8%) | Antiplatelets agents | 3 (37.5) | |
Cortisone | 2 (25) | ||
Diuretics | 2 (25) | ||
Proton-pump inhibitor | 1 (12.5) | ||
Diuretics 6 (8.8%) | Cardiotonic | 2 (33.6) | |
Oral hypoglycemic agents | 1 (16.6) | ||
Antiepileptic | 1 (16.6) | ||
Anxiolytics | 1 (16.6) | ||
Antiplatelets agents | 1 (16.6) | ||
Anxiolytics 5 (7.3%) | Cortisone | 1 (20) | |
Sedative-hypnotic | 4 (80) | ||
Antihypertensive 2 (2.9%) | Antiplatelets agents | 1 (50) | |
Cortisone | 1 (50) |
Detrimental Modalities and Applied Means According to Victims’ Sex and Cause of Death in Simple (Nor Complex, Complicated) Suicides | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Detrimental Modality | Applied Mean | Total | % | Sex | Cause of Death | Total | % | ||||
M | % | F | % | ||||||||
Violent suicides—246 cases 85.5% | Falling from a height (3–27 m) | 145 | 94.8 | 87 | 60 | 58 | 40 | Skeletal-visceral injuries | 138 | 95.1 | |
Brain injuries | 7 | 4.9 | |||||||||
Pedestrian running over | Train (5 cases—62.5%) | 8 | 5.2 | 7 | 87.5 | 1 | 12.5 | Body disruption | 6 | 75 | |
Subway (3 cases—37.5%) | Brain disruption | 2 | 25 | ||||||||
Gunshot | Gun (46 cases—88.5%) | 52 | 18 | 48 | 92.3 | 4 | 7.7 | Brain injuries | 46 | 88.4 | |
Shotgun (6 cases—11.5%) | Cardio-pulmonary injuries | 5 | 9.6 | ||||||||
Acute bleeding due to vascular lesions | 1 | 2 | |||||||||
Hanging | Rope (17 cases—50%) | 34 | 12 | 30 | 88.2 | 4 | 11.8 | Hanging mechanical asphyxia | 34 | 100 | |
Electric cable (6 cases—17.5%) | |||||||||||
Roller shutter belt (1 case—3%) | |||||||||||
Mountaineer rope (1 case—3%) | |||||||||||
Clothing (7 cases—20.5%) | |||||||||||
Scarf (1 case—3%) | |||||||||||
Shoelaces (1 case—3%) | |||||||||||
Sharp force trauma | Knife (5 cases—71.4%) | 7 | 2.5 | 4 | 57.1 | 3 | 42.9 | Acute bleeding due to vascular lesions | 4 | 57.1 | |
Internal submersion | 1 | 14.3 | |||||||||
Razor (1 case—14.3%) | Cardio-pericardial injuries | 1 | 14.3 | ||||||||
Scalpel (1 case—14.3%) | Lung injuries | 1 | 14.3 | ||||||||
Non-violent suicides—37 cases 14.5% | Chemical | Antidepressants (9 cases—39%) | 23 | 8 | 11 | 48.2 | 12 | 51.8 | Acute drug poisoning | 14 | 60.8 |
Anxiolytics (3 cases—13%) | |||||||||||
Insulin (2 cases—8.8%) | |||||||||||
Acid caustic substances (2 cases—8.8%) | Esophagus-gastric perforation | 3 | 13.2 | ||||||||
Acid caustic substances (1 case—4.4%) | |||||||||||
Carbon monoxide (CO) (6 cases—26%) | Acute carbon monoxide intoxication | 6 | 26 | ||||||||
Drowning | River (7 cases—87.5%) | 8 | 3 | 4 | 50 | 4 | 50 | Asphyxia by drowning | 8 | 100 | |
Lake (1 case—12.5%) | |||||||||||
Plastic bag suffocation | Plastic bag (6 cases—100%) | 6 | 2 | 4 | 66.6 | 2 | 33.4 | Plastic bag suffocation | 6 | 100 |
Violent Suicide | Non-Violent Suicide | ||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Body Area | Site | Falling from a Height | Pedestrian Run over | Gunshot | Hanging | Sharp Force Trauma | Chemical | Drowning | Plastic Bag Suffocation | Complex Suicide | Complicated Suicide | ||||||||||
M | F | M | F | M | F | M | F | M | F | M | F | M | F | M | F | M | F | M | F | ||
Head | Brain | 2 | 3 | 2 | 1 | 1 | |||||||||||||||
Ear | 1 | ||||||||||||||||||||
Tongue | 1 | 1 | 1 | 1 | |||||||||||||||||
Neck | Pharynx | 2 | |||||||||||||||||||
Thyroid | 1 | 3 | 1 | 1 | |||||||||||||||||
Larynx | 6 | 1 | 4 | 2 | 2 | ||||||||||||||||
Chest | Esophagus | 2 | 2 | ||||||||||||||||||
Breast | 18 | 1 | 3 | 4 | 1 | 2 | |||||||||||||||
Lung | 18 | 3 | 1 | 9 | 5 | 2 | 1 | 1 | |||||||||||||
Abdomen | Liver | 6 | 2 | 1 | 1 | 1 | |||||||||||||||
Biliary tract | 4 | ||||||||||||||||||||
Pancreas | 6 | 1 | 2 | 2 | 2 | ||||||||||||||||
Stomach | 7 | 1 | 1 | 2 | 1 | ||||||||||||||||
Duodenum | 1 | ||||||||||||||||||||
Colon | 7 | 9 | 1 | 5 | 1 | 2 | 1 | ||||||||||||||
Rectum | 1 | 2 | 1 | 1 | 1 | 3 | |||||||||||||||
Peritoneum | 2 | ||||||||||||||||||||
Reproductive System | Testicle | 1 | 1 | 1 | 2 | ||||||||||||||||
Prostate | 11 | 2 | 12 | 4 | 2 | 2 | 2 | 1 | |||||||||||||
Ovary | 3 | ||||||||||||||||||||
Uterus | 9 | 2 | 1 | ||||||||||||||||||
Urinary System | Kidney | 3 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | ||||||||||||
Bladder | 4 | 1 | 1 | 3 | 2 | 1 | |||||||||||||||
Immune System | Lymphocytes | 4 | 1 | 1 | 5 | 1 | 1 | 2 | 1 | ||||||||||||
Integumentary System | Skin | 2 | 1 | 2 | |||||||||||||||||
Skeletal System | Bone | 1 |
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Gentile, G.; Tambuzzi, S.; Calati, R.; Zoja, R. A Descriptive Cohort of Suicidal Cancer Patients: Analysis of the Autopsy Case Series from 1993 to 2019 in Milan (Italy). Int. J. Environ. Res. Public Health 2022, 19, 829. https://doi.org/10.3390/ijerph19020829
Gentile G, Tambuzzi S, Calati R, Zoja R. A Descriptive Cohort of Suicidal Cancer Patients: Analysis of the Autopsy Case Series from 1993 to 2019 in Milan (Italy). International Journal of Environmental Research and Public Health. 2022; 19(2):829. https://doi.org/10.3390/ijerph19020829
Chicago/Turabian StyleGentile, Guendalina, Stefano Tambuzzi, Raffaella Calati, and Riccardo Zoja. 2022. "A Descriptive Cohort of Suicidal Cancer Patients: Analysis of the Autopsy Case Series from 1993 to 2019 in Milan (Italy)" International Journal of Environmental Research and Public Health 19, no. 2: 829. https://doi.org/10.3390/ijerph19020829