Suicide drowning in the non-coastal territory of Milan.
BACKGROUND
A cadaver in water sets a relevant issue for the forensic pathologist, concerning the differential diagnosis between homicide, suicide, accidental event, and natural death in water. In the present study, the drowning suicides in a non-coastal territory are analyzed, discussing the main diagnostic difficulties, the preventive intervention, and the strategies for outlining the profile of a "mean victim" that is at risk of committing suicide by drowning.


METHODS
The cases of drowning suicide were extrapolated by the database of the 21,472 autopsies performed at the Civic Morgue of Milan, in the period between 1993 and 2013.


RESULTS
Drowning represents the fifth cause of suicide registered in Milan for the study period, with 139 cases (3.8% of all suicides). Victims were mainly elderly males (61-80 years old) with a history of psychiatric diseases in pharmacological therapy; they committed suicide mainly during summer, in the rivers. The diatoms test was positive in 82 cases (59%) and highlighted typical taxa of fresh water. Alcohol and illicit drugs were not noticed, at high levels.


CONCLUSIONS
Drowning suicide occurs even in a non-coastal territory, far from the sea, if there is an easy access to the water: specifically, many natural and artificial waterways in the Milan district represent a high-risk factor predisposing the drowning suicide.
Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133, Milano, Italy.
Enrico
E
Muccino
Graziano Domenico Luigi
GD
Crudele
Guendalina
G
Gentile
Matteo
M
Marchesi
Alessandra
A
Rancati
Riccardo
R
Zoja
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D017377:Diatoms / Q000302:isolation & purification; D004332:Drowning / Q000401:mortality*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D013405:Suicide / Q000706:statistics & numerical data*; D055815:Young Adult