Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007

Canturk, Nergis; SARI, Hüseyin; CANTÜRK, Gürol; YAVUZ, MEHMET SUNAY; AŞIRDİZER, Mahmut

Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007

Mahmut AŞIRDİZER, (Celal Bayar Üniversitesi, Tıp Fakültesi, Adli Tıp Anabilim Dalı, Manisa, Türkiye)

Gürol CANTÜRK, (Ankara Üniversitesi, Tıp Fakültesi, Adli Tıp Anabilim Dalı, Ankara, Türkiye)

Nergis CANTÜRK, (Adli Tıp Kurumu Ankara Grup Başkanlığı, Ankara, Türkiye)

Mehmet Sunay YAVUZ, (Celal Bayar Üniversitesi, Tıp Fakültesi, Adli Tıp Anabilim Dalı, Manisa, Türkiye)

Hüseyin SARI (Adli Tıp Kurumu, İstanbul, Türkiye)

Ulusal Travma ve Acil Cerrahi Dergisi

3 1

Yıl: 2010 Cilt: 16 Sayı: 1 Sayfa Aralığı: 47 - 53 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007

Öz:

AMAÇ İntihar amaçlı ateşli silah ölümlerinin bazı özellikleri önceki çalışmalarda tanımlanmış ise de, av tüfekleri kullanılarak gerçekleştirilmiş intihar ölümlerine ait seriler, literatürde sınırlı sayıdadır. Bu çalışmanın amacı, intihar amaçlı av tüfeği ölümlerinin çeşitli özelliklerini tanımlamaktır. GEREÇ VE YÖNTEM 01 Ocak 1998 ile 31 Aralık 2007 tarihleri arasında Adli Tıp Kurumu, Morg İhtisas Dairesi tarafından düzenlenmiş, 36971 otopsi raporu geriye dönük olarak gözden geçirildi. BULGULAR Yetmiş üç intihar amaçlı av tüfeği ölüm olgusu değerlendirildi. Olguların 46’sı (%63) erkek, 27’si (%37) kadındı. Olguların çoğu (n=39, %53,4) 16-20 yaş grubunda yer almaktaydı (p<0,001). İntiharların 62’si (%84,9) kurbanın evinde meydana gelmişti (p<0,001). Yedi olguda intihar notu (%9,6) bulunmuştu. Giriş yaraları olguların büyük çoğunluğunda (n=29, %39,8) kafa bölgesinde iken (p<0,001), kadın kurbanlarda intihar için genellikle (n=12, %44,4) karın bölgesinde idi. Atış, olguların 56’sında (%76,7) tam temas halinde, bitişik atış (gevşek temas) mesafesinden gerçekleştirilmişti (p<0,001). Olguların %17,8’inde (n=13) kanda etil alkol saptanmıştı. SONUÇ Av tüfekleri ile intiharların önlenebilmesi için, av tüfeklerinin elde edilmesi ve kullanımı sıkı olarak kontrol edilmeli, eğitim çabaları erken ve geç adölesan dönemindeki gençlere ebeveynlerine yönelmeli, psikolojik destek merkezleri kurulmalıdır.

Anahtar Kelime:

Konular: Cerrahi

İstanbul?daki av tüfeği intiharlarının analizi, 1998-2007

Öz:

BACKGROUND In previous studies, some features of suicidal firearm deaths have been described, but series of suicidal deaths using shotgun are limited in the literature. The aim of the present study was to define several characteristics of suicidal shotgun deaths. METHODS In this study, we reviewed retrospectively 36,971 autopsy reports recorded by the Mortuary Section of the Forensic Medicine Council of Istanbul between January 1, 1998 and December 31, 2007. RESULTS Seventy-three shotgun-related suicide cases were evaluated. Of the 73 cases, 46 (63%) were male and 27 (37%) were female. Most of the cases (n=36, 53.4%) were aged 16-20 years (p<0.001). Sixty-two of the suicides (84.9%) occurred in victims’ homes (p<0.001). A suicide note was recovered in 7 cases (9.6%). While entry wounds were on the head in the majority of the cases (n=29, 39.8%) (p<0.001), in nearly half of the female victims (n=12; 44.4%), entry wound was in the abdominal region. Fifty-six shots (76.7%) were determined to be from loose-contact range (p<0.001). Ethyl alcohol was detected in 17.8% (n=13) of blood samples of the cases. CONCLUSION Handling and usage of shotguns should be under strict control, educational efforts should be directed to early and late adolescents and their parents and psychological support centers should also be founded in an effort to prevent suicidal deaths with shotguns.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Ozanne-Smith J, Ashby K, Newstead S, Stathakis VZ, Clapperton A. Firearm related deaths: the impact of regulatory reform. Inj Prev 2004;10:280-6.
2. Richmond TS, Schwab CW, Riely J, Branas CC, Cheney R, Dunfey M. Effective trauma center partnerships to address firearm injury: a new paradigm. J Trauma 2004;56:1197-205.
3. Shenassa ED, Catlin SN, Buka SL. Lethality of firearms relative to other suicide methods: a population based study. J Epidemiol Community Health 2003;57:120-4.
4. Miller M, Azrael D, Hemenway D. The epidemiology of case fatality rates for suicide in the northeast. Ann Emerg Med 2004;43:723-30.
5. Desjeux G, Labarère J, Galoisy-Guibal L, Ecochard R. Suicide in the French armed forces. Eur J Epidemiol 2004;19:823-9.
6. Rosengart M, Cummings P, Nathens A, Heagerty P, Maier R, Rivara F. An evaluation of state firearm regulations and homicide and suicide death rates. Inj Prev 2005;11:77-83.
7. Moug SJ, Lyle JA, Black M. A review of gunshot deaths in Strathclyde--1989 to 1998. Med Sci Law 2001;41:260-5.
8. Goren S, Subasi M, Tirasci Y, Kemaloglu S. Firearm-related mortality: a review of four hundred-forty four deaths in Diyarbakir, Turkey between 1996 and 2001. Tohoku J Exp Med 2003;201:139-45.
9. Wiebe DJ. Homicide and suicide risks associated with firearms in the home: a national case-control study. Ann Emerg Med 2003;41:771-82.
10. Cetin G, Yorulmaz C. Firearm injury. In: Soysal Z, Cakalir C, editors. Forensic medicine. Vol. 2. Istanbul: Istanbul University Press and Film Center; 1999. p. 561-86.
11. Tamosiunas A, Reklaitiene R, Virviciute D, Sopagiene D. Trends in suicide in a Lithuanian urban population over the period 1984-2003. BMC Public Health 2006;6:184.
12. Kennedy M. Guns in Wisconsin. WMJ 2001;100:12-6.
13. Li S, Hauser LA, Gao B. Suicide in Travis County, Texas, from 1994 through 1998. Tex Med 2001;97:64-8.
14. Doddakashi V, Wilcox RE, Hauser LA. Female suicides in major Texas cities, 1994 through 1998. Tex Med 2003;99:50-8.
15. Ziyalar N, Sirma G. Women suicides. In: Coltu A, editor. 2nd Forensic Sciences Congress, Oral and Poster Presentations Book. Bursa: The Publication House of Uludag University; 1996. p. 38.
16. Polat O. Forensic medicine. Istanbul: Der Publication; 2000. p. 247-54.
17. Sutton L, Hawton K, Simkin S, Turnbull P, Kapur N, Bennewith O, et al. Gunshot suicides in England--a multicentre study based on coroners’ records. Soc Psychiatry Psychiatr Epidemiol 2005;40:324-8.
18. Druid H. Site of entrance wound and direction of bullet path in firearm fatalities as indicators of homicide versus suicide. Forensic Sci Int 1997;88:147-62.
19. Altındag A, Ozdemir B, Yanik M. Firearm suicides in Sanliurfa. Anatolian Journal of Psychiatry 2005;6:240-4.
20. Saeed A, Bashir MZ, Khan D, Iqbal J, Raja KS, Rehman A. Epidemiology of suicide in Faisalabad. J Ayub Med Coll Abbottabad 2002;14:34-7.
21. Asirdizer M, Canturk G, Sari H, Cansunar FN. Analysis of deaths occurred in puberty, early adolescent and late adolescent periods. In: Kırangil SB, editor. 1st National Congress of Forensic Medicine, Book of Congress. Istanbul: Ozgun Offset; 1998. p. 1-12.
22. Kung HC, Pearson JL, Liu X. Risk factors for male and female suicide decedents ages 15-64 in the United States. Results from the 1993 National Mortality Followback Survey. Soc Psychiatry Psychiatr Epidemiol 2003;38:419-26.
23. Zacharakis CA, Hadjivassilis V, Madianos MG, Papadimitriou GN, Stefanis CN. Suicide in cyprus 1988-1999. Eur Psychiatry 2005;20:110-4.
24. Ağritmiş H, Yayci N, Colak B, Aksoy E. Suicidal deaths in childhood and adolescence. Forensic Sci Int 2004;142:25-31.
25. Tuzun B, Sozen S, Dokgoz H, Fincanci SK. Deaths in adolescence. Bull Forensic Med 1997;2:67-70.
26. Salacin S, Cekin N, Gulmen MK, Ozdemir MH, Sen F, Savran B. The origin and the cause of death in childhood deaths in Adana. In: Kırangil SB, editor. 1st National Congress of Forensic Medicine, Book of Congress. Istanbul: Ozgun Offset; 1998. p. 23-8.
27. Katkici U, Ozkok S, Ozkara E. The evaluation of suicide in Sivas County. In: Salacin S, Gulmen MK, Cekin N, Ozdemir MH, editors. 1st Congress of Forensic Sciences, Book of Congress. Adana: Publication of Cukurova University; 1994. p. 115-8.
28. Malmberg A, Hawton K, Simkin S. A study of suicide in farmers in England and Wales. J Psychosom Res 1997;43:107-11.
29. Desinan L, Mazzolo GM. Gunshot fatalities: suicide, homicide or accident? A series of 48 cases. Forensic Sci Int 2005;147 Suppl:S37-40.
30. Kuwabara H, Shioiri T, Nishimura A, Abe R, Nushida H, Ueno Y, et al. Differences in characteristics between suicide victims who left notes or not. J Affect Disord 2006;94:145-9.
31. Salib E, Cawley S, Healy R. The significance of suicide notes in the elderly. Aging Ment Health 2002;6:186-90.
32. Schmeling A, Strauch H, Rothschild MA. Female suicides in Berlin with the use of firearms. Forensic Sci Int 2001;124:178-81.
33. Meel BL. Determinants of suicide in the Transkei sub-region of South Africa. J Clin Forensic Med 2003;10:71-6.
34. Mohanty S, Sahu G, Mohanty MK, Patnaik M. Suicide in India: a four year retrospective study. J Forensic Leg Med 2007;14:185-9.
35. Kohlmeier RE, McMahan CA, DiMaio VJ. Suicide by firearms: a 15-year experience. Am J Forensic Med Pathol 2001;22:337-40.
36. DiMaio VJM. Gunshot wounds. 2nd ed. New York: CRC Press; 1999. p. 356.
37. Azmak D, Altun G, Bilgi S, Yilmaz A. Firearm fatalities in Edirne, 1984-1997. Forensic Sci Int 1998;95:231-9.
38. Azmak D, Altun G, Koç S, Yorulmaz C, Ozaslan A. Intra- and perioral shooting fatalities. Forensic Sci Int 1999;101:217-27.
39. Albek E, Yorulmaz C, Ozaslan A, Koç S, Agir G, Cetin G. The deaths due to firearm injuries in aspect of suicidal origin. In: Kolusayin O and Yavuz MF, editors. 8th National Days of Forensic Medicine, Book of Poster Presentations. Istanbul: Dilek Offset; 1995. p. 277-82.
40. Karger B, Billeb E, Koops E, Brinkmann B. Autopsy features relevant for discrimination between suicidal and homicidal gunshot injuries. Int J Legal Med 2002;116:273-8.
41. Cina SJ, Ward ME, Hopkins MA, Nichols CA. Multifactorial analysis of firearm wounds to the head with attention to anatomic location. Am J Forensic Med Pathol 1999;20:109-15.
42. Cetin G, Cansunar FN, Asirdizer M, Soysal Z, Ozer C. The evaluation of cases which defined psychopathic incisions and tattoo during medico-legal autopsies. In: Salacin S, Gulmen MK, Cekin N, Ozdemir MH, editors. 1st Congress of Forensic Sciences, Book of Congress. Adana: Publication of Cukurova University; 1994. p. 243-4.
43. Mukamal KJ, Kawachi I, Miller M, Rimm EB. Drinking frequency and quantity and risk of suicide among men. Soc Psychiatry Psychiatr Epidemiol 2007;42:153-60.
44. Värnik A, Kõlves K, Väli M, Tooding LM, Wasserman D. Do alcohol restrictions reduce suicide mortality? Addiction 2007;102:251-6.
45. May PA, Van Winkle NW, Williams MB, McFeeley PJ, De- Bruyn LM, Serna P. Alcohol and suicide death among American Indians of New Mexico: 1980-1998. Suicide Life Threat Behav 2002;32:240-55.

APA	AŞIRDİZER M, CANTÜRK G, Canturk N, YAVUZ M, SARI H (2010). Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007. , 47 - 53.
Chicago	AŞIRDİZER Mahmut,CANTÜRK Gürol,Canturk Nergis,YAVUZ MEHMET SUNAY,SARI Hüseyin Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007. (2010): 47 - 53.
MLA	AŞIRDİZER Mahmut,CANTÜRK Gürol,Canturk Nergis,YAVUZ MEHMET SUNAY,SARI Hüseyin Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007. , 2010, ss.47 - 53.
AMA	AŞIRDİZER M,CANTÜRK G,Canturk N,YAVUZ M,SARI H Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007. . 2010; 47 - 53.
Vancouver	AŞIRDİZER M,CANTÜRK G,Canturk N,YAVUZ M,SARI H Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007. . 2010; 47 - 53.
IEEE	AŞIRDİZER M,CANTÜRK G,Canturk N,YAVUZ M,SARI H "Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007." , ss.47 - 53, 2010.
ISNAD	AŞIRDİZER, Mahmut vd. "Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007". (2010), 47-53.

APA	AŞIRDİZER M, CANTÜRK G, Canturk N, YAVUZ M, SARI H (2010). Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007. Ulusal Travma ve Acil Cerrahi Dergisi, 16(1), 47 - 53.
Chicago	AŞIRDİZER Mahmut,CANTÜRK Gürol,Canturk Nergis,YAVUZ MEHMET SUNAY,SARI Hüseyin Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007. Ulusal Travma ve Acil Cerrahi Dergisi 16, no.1 (2010): 47 - 53.
MLA	AŞIRDİZER Mahmut,CANTÜRK Gürol,Canturk Nergis,YAVUZ MEHMET SUNAY,SARI Hüseyin Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007. Ulusal Travma ve Acil Cerrahi Dergisi, vol.16, no.1, 2010, ss.47 - 53.
AMA	AŞIRDİZER M,CANTÜRK G,Canturk N,YAVUZ M,SARI H Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007. Ulusal Travma ve Acil Cerrahi Dergisi. 2010; 16(1): 47 - 53.
Vancouver	AŞIRDİZER M,CANTÜRK G,Canturk N,YAVUZ M,SARI H Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007. Ulusal Travma ve Acil Cerrahi Dergisi. 2010; 16(1): 47 - 53.
IEEE	AŞIRDİZER M,CANTÜRK G,Canturk N,YAVUZ M,SARI H "Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007." Ulusal Travma ve Acil Cerrahi Dergisi, 16, ss.47 - 53, 2010.
ISNAD	AŞIRDİZER, Mahmut vd. "Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007". Ulusal Travma ve Acil Cerrahi Dergisi 16/1 (2010), 47-53.