Demographics of suicide victims in Sweden in relation to their blood-alcohol concentration and the circumstances and manner of death

Forensic Sci Int. 2010 May 20;198(1-3):17-22. doi: 10.1016/j.forsciint.2009.12.015. Epub 2010 Jan 6.

Abstract

Specimens of blood and other body fluids were obtained at autopsy from all deaths in Sweden classified as suicide covering a 10-year period (N=11,441 cases). The mean age (+/-standard deviation, SD) of the victims was 51.3+/-18.8 years with a clear predominance of males 71% (mean age 51.3+/-18.8 years) compared with 29% females (mean age 51.4+/-18.9 years). The concentration of ethanol in blood samples was determined in duplicate by headspace gas chromatography and a mean blood-alcohol concentration (BAC) of 0.1g/L (10mg/100mL) was the cut-off used to identify ethanol positive cases. The suicides were coded (ICD-9) as self-poisonings (N=2462, 22%), hanging (N=4474, 39%), asphyxia by gas (N=509, 4.4%), drowning (N=803, 7.0%), gun shot (N=1307, 11.4%), fall from height (N=632, 5.5%), self-inflicted cuts or sharp-force injury (N=363, 3.1%) and miscellaneous ways (N=891, 7.8%). On average 34% of all suicide victims in Sweden had consumed alcohol before death, 36% of the males and 31% of the females had a positive BAC. The mean (median) concentration of alcohol in femoral blood for men was 1.34g/L (1.3g/L) compared with 1.25g/L (1.1g/L) for women. Many victims were heavily intoxicated and the 90th percentiles of the BAC distributions ranged from 2.3 to 2.8g/L depending on manner of death. Elevated blood-alcohol was most prevalent in poisoning deaths (45%) and gas asphyxia (51%) and least prevalent in falls from height (19%) and sharp-force injury (18%). Toxicological analysis for presence of drugs other than alcohol showed a predominance of paracetamol, SSRI antidepressants, anti-psychotics, sedative-hypnotics, and centrally acting opioids. A host of psycho-social factors drive a person to commit suicide and one of the catalysts is over-consumption of alcohol and acute alcohol intoxication. Heavy drinking leads to a loss of inhibitions, impulsive behaviour, poor judgment and a tendency to take risks, all of which might increase the propensity of predisposed individuals to take their own lives.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Asphyxia / mortality
  • Central Nervous System Depressants / blood*
  • Child
  • Chromatography, Gas
  • Drowning / mortality
  • Ethanol / blood*
  • Female
  • Forensic Toxicology
  • Humans
  • Male
  • Middle Aged
  • Poisoning / mortality
  • Sex Distribution
  • Suicide / statistics & numerical data*
  • Sweden / epidemiology
  • Wounds, Gunshot / mortality
  • Wounds, Stab / mortality

Substances

  • Central Nervous System Depressants
  • Ethanol