Psychic trauma as cause of death.
OBJECTIVE
of study Psychic trauma is described as the action of 'an emotionally overwhelming factor' capable of causing neurovegetative alterations leading to transitory or persisting bodily changes. The medico-legal concept of psychic trauma and its definition as a cause in penal cases is debated. The authors present three cases of death after psychic trauma, and discuss the definition of cause within the penal ambit of identified 'emotionally overwhelming factors'.


METHODS
The methodological approach to ascertainment and criterion-based assessment in each case involved the following phases: (1) examination of circumstantial evidence, clinical records and documentation; (2) autopsy; (3) ascertainment of cause of death; and (4) ascertainment of psychic trauma, and its coexisting relationship with the cause of death.


RESULTS
The results and assessment of each of the three cases are discussed from the viewpoint of the causal connotation of psychic trauma. In the cases presented, psychic trauma caused death, as deduced from assessment of the type of externally caused emotional insult, the subjects' personal characteristics and the circumstances of the event causing death.


CONCLUSIONS
In cases of death due to psychic trauma, careful methodological ascertainment is essential, with the double aim of defining 'emotionally overwhelming factors' as a significant cause of death from the penal point of view, and of identifying the responsibility of third parties involved in the death event and associated dynamics of homicide.
Section of Legal Medicine, Department of Environmental Medicine and Public Health, Italy.
C
C
Terranova
R
R
Snenghi
G
G
Thiene
S D
SD
Ferrara
D000063:Accidents, Traffic / Q000523:psychology; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000473:pathology; D002311:Cardiomyopathy, Dilated / Q000473:pathology; D054541:Family Conflict / Q000523:psychology; D049429:Forensic Pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000209:etiology* / Q000473:pathology; D013315:Stress, Psychological / Q000150:complications*; D014693:Ventricular Fibrillation / Q000209:etiology*; D014754:Violence / Q000523:psychology