Abstract

Introduction: Hanging is an important cause of homicidal and suicidal injury in adults, but in adolescents, it is usually accidental, leading to death because of asphyxia as a result of partial or complete hanging. Though rarely observed in children less than 12 years of age, suicide by hanging is a common cause of unnatural death in adolescents, and there are several recent examples. The most common suicidal methods among adolescents are hanging, the use of firearm, jumping from height, drowning and poisoning. Case Details: The authors describe three incidents in a metropolitan city, where an adolescent was brought to hospital after being found hanging in his/her own residence by their parents. In the first case, the victim was a 16 year old girl, who was found hanging from ceiling fan using her dupatta. In the second case, a 14 year old girl allegedly committed suicide by hanging herself after her parents had rebuked him regarding his academic performance. In the third case, a 13 year old boy allegedly hanged himself while trying to emulate the suicidal hanging shown in a crime thriller series. The authors discuss the suicide notes found in these cases and also the post-mortem examination findings in each case. Conclusion: The authors try to analyze factors associated with death due to hanging in adolescents and also identify areas of intervention for preventing such deaths. The predisposing and precipitating factors in these cases observed were love affair related strife, examination related pressure and emulating television stunts. This case series highlights the importance of crime scene reconstruction to evaluate manner of death in obscure cases.

• 1.   Bhosle SH, Zanjad NP, Dake MD, Godbole HV. Deaths due to hanging among adolescents-A 10-year retrospective study. Journal of Forensic and Legal Medicine. 2015;29:30–33.
• 2.   World Health Organization. Child and Adolescent Health and Development. www.who.int/childadolescent-health/OVERVIEW/AHD/adh_over. html.
• 3.   Diane S, Michael W. An approach to interviewing adolescents. Pediatric Child Health 2003 Nov;8(9):554–56.
• 4.   Boergers J, Spinto A, Donaldson D. Reasons for Adolescent Suicide Attempts: Associations with Psychological Functioning. Journal of Am Acad. Child Adolescent Psychiatry. 1998 December;37(12):1287–93.
• 5.   Kar N, Pany M, Mishra BN, Sengupta J, Das IRisk factors of adolescent suicide attempt. J East Zonal Branch Indian Psychiatric Society. 1996;1:17–22.
• 6.   Government of India. Accidental deaths and suicide in India. National Crime Records Bureau. Ministry of Home Affairs .2016.
• 7.   Reddy KSN. The Essentials of Forensic Medicine and Toxicology, 34th edition. Hyderabad: K Suguna Devi 2017.p.315.
• 8.   Saukko P, Knight B. Fatal pressure on the Neck. Forensic pathology, 4th edition. Boca Raton: CRC Press. 2016.pp.369–97.
• 9.   DiMaio VJ, Dimaio D. Asphyxia. Forensic Pathology. 2nd edition. Boca Raton: CRC Press; 2001.pp.232–78.
• 10.   Matiharan K, Patnaik AK. Asphyxia. Modi’s Medical Jurisprudence and Toxicology, 23rd edition. New Delhi, India; Lexis Nexis; 2005. pp.567–614.
• 12.   Aggarwal A. Mechanical Asphyxia. Textbook of Forensic Medicine and Toxicology. New Delhi, India: Avichal Publishing Company; 2014. pp.366–404.
• 13.   Vij K. Asphyxial deaths. Textbook of Forensic Medicine and Toxicology: Principles and practice, 6th edition. New Delhi, India: Elsevier India Pvt Ltd; 2014.pp.110–45.
• 14.   Rao NG. Violent Asphyxial deaths. Textbook of Forensic Medicine & Toxicology; New Delhi, India: Jaypee Brothers; 2010.pp.194–220.
• 15.   Pillay VV. Mechanical Asphyxia. Textbook of Forensic Medicine & Toxicology, 17th edition. Hyderabad: Paras Medical Publisher; 2016. pp.297–327.
• 16.   Nandy A. Asphyxial Deaths. Principle of Forensic Medicine including Toxicology, 3rd edition. India: Central Book Agency; 2010.pp.517–64.
• 17.   C.K. Parikh. Asphyxia. Parikh’s textbook of Medical Jurisprudence Forensic Medicine & Toxicology,6th edition. CBS Publisher’s & distributors; 1999.pp.3.40–3.53.
• 18.   Lalwani S, Sharma GASK, Kabra SK, et al. Suicide among children and adolescents in South Delhi 1991–2000. Indian J Pediatr. 2004 Aug;71(8):701–3.
• 19.   National Crime Record Bureau. 2014. Incidence and rates of suicide in India.[Internet] Available from:http://ncrb.gov.in/StatPublications/ ADSI/ADSI2014/chapter-2%20 suicides.pdf [updated 2019 Jan 08; accessed 2019 Jan 10].
• 20.   Shakya KN, Bhatta A and Bhandari B. A case report on attempted suicide by hanging of an adolescent girl. Journal of Kathmandu Medical College. 2017 Apr–Jun;6(2):78–80.
• 21.   Brent DA, Baugher M, Bridge J, Chen T, & Chiappetta L, et al. Age and sex-related risk factors for adolescent suicide. Journal of the American Academy of Child and Adolescent Psychiatry. 1999;38:1497–1505.
• 22.   Vijayakumari N, Suicidal hanging: a prospective study. J Indian Acad Forensic Med. 2011 Oct-Dec;33(4):355–7.
• 23.   Elizabeth D. Handley. Mother-Daughter Interpersonal Processes Underlying the Association between Child Maltreatment and Adolescent Suicide Ideation. Journal of the American Association of Suicidology. 2018:1–9.
• 24.   Sadock BJ and Sadock VA. Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/ Clinical Psychiatry. 10th Edition. Philadelphia: Lippincott Williams and Wilkins; 2007.
• 25.   Piaget J. The origins of intelligence in children [M. Cook, Trans.]. New York: International Universities Press; 1952.
• 26.   Graham Martin. Archives of Suicide Research. The influence of television suicide in a normal adolescent population. 1996;2(2):103–17.
• 27.   Gould MS, Shaffer D. Evidence of imitation. The impact of suicide in television movies: Evidence of imitation. Engl J Med. 1986;315:690–94.