Forensic Evaluation of Suicide
DOI:
https://doi.org/10.38035/jim.v5i1.1941Keywords:
Suicide, Psychological Autopsy, PMCT, Literature ReviewAbstract
Suicide is one of the causes of unnatural death that has complex medical, psychological, and legal implications. Forensic evaluation of suicide cases often faces challenges due to overlapping pathological findings with accident and homicide cases, especially in cases of hanging and complex suicide. This study aims to systematically analyze forensic evaluation approaches in suicide cases through the integration of conventional autopsy, Post-Mortem Computed Tomography (PMCT), psychological autopsy, toxicology examination, and other contextual analyses. This study uses the Systematic Literature Review (SLR) method with reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 25 articles published between 1992 and 2025 that met the inclusion criteria were analyzed qualitatively. Data were extracted and synthesized to identify research methods, key findings, and the contributions of each approach to forensic suicide evaluation. The results of the study show that conventional autopsy is still the primary method for determining the cause of death, but it has limitations when used alone. The integration of PMCT has been shown to improve the objective detection of neck injuries and internal findings. Psychological autopsy plays an important role in uncovering the psychological and social factors of the victim, especially in ambiguous deaths. Toxicological examination provides crucial information regarding the influence of psychoactive substances on the victim's behavior, while forensic linguistic analysis helps authenticate wills and understand the motives for suicide. In complex suicide cases, a multidisciplinary approach is an absolute necessity.
References
Ampanozi, G., et al. (2022). Comparison of autopsy and PMCT findings in suicidal hangings. International Journal of Legal Medicine, 136, 1567–1576. https://doi.org/10.1007/s00414-022-02874-2
Arsenault-Lapierre, G., Kim, C., & Turecki, G. (2004). Psychiatric diagnoses in 3275 suicides: A meta-analysis. BMC Psychiatry, 4, 37. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-4-37
Bugelli, V., et al. (2022). Suicidal behavior and its relationship with postmortem toxicology. Journal of Forensic Sciences, 67(4), 1540–1549. https://pmc.ncbi.nlm.nih.gov/articles/PMC9229491/
Catanesi, R., et al. (2022). The role of psychological autopsy in investigating a case of atypical suicide in schizophrenia. Egyptian Journal of Forensic Sciences, 12(1), 1–7. https://ejfs.springeropen.com/articles/10.1186/s41935-022-00291-5
Cummins, N., et al. (2025). Acoustic and machine learning methods for speech-based suicide risk assessment: A systematic review. arXiv. https://arxiv.org/abs/2505.18195
De Leo, D., & Sveticic, J. (2025). Psychological autopsy: Overview of equivocal deaths, suicides and homicide-suicides. Journal of Forensic and Legal Medicine, 102813. https://doi.org/10.1016/j.jflm.2025.102813
De Matteis, M., et al. (2024). Suicidal decapitation by hanging: A systematic review. Forensic Science International. https://pubmed.ncbi.nlm.nih.gov/38838410/
Hasanuddin, A., et al. (2021). Forensic analysis of hanging cases: Suicide or homicide. Forensic Medicine Journal. https://fmj.fk.umi.ac.id/index.php/fmj/article/view/579
Hawton, K., Williams, K., & Haw, C. (2003). Psychological autopsy studies of suicide: A systematic review. Psychological Medicine, 33(3), 395–405. https://pubmed.ncbi.nlm.nih.gov/12701661/
Hidayat, R., & Nuraini, L. (2022). Analysis of suicide will profiling: A forensic linguistic study. Anwarul Journal. https://ejournal.yasin-alsys.org/anwarul/article/view/1595
Isometsä, E. T. (1992). Procedures and problems in conducting a psychological autopsy. Medicine, Science and the Law, 36(1), 13–18. https://doi.org/10.1177/0306624X9203600105
Khan, M. M. (2025). The psychological autopsy: Unraveling the mind of the deceased. Annals of Medical and Public Health. https://ampphealthjournal-network.org/wp-content/uploads/2024/12/AMPPH_2025_196_201.pdf
Palermo, G. B., & Gudjonsson, G. H. (2021). Mind the past: A systematic review on psychological autopsy. Behavioral Sciences & the Law, 39(5), 620–636. https://onlinelibrary.wiley.com/doi/10.1002/bsl.2619
Patil, A., et al. (2024). Neck findings in hanging: A comparative study of conventional autopsy and postmortem CT. Cureus, 16(3), e92518. https://doi.org/10.7759/cureus.92518
Putra, I. P. A., et al. (2023). Homicide by hanging: A comprehensive review of published literature. Indonesian Journal of Legal and Forensic Sciences. https://ojs.unud.ac.id/index.php/ijlfs/article/view/92279
Rahmawati, D. (2022). Psychological risk factors for suicide among prison inmates: A literature review. Santhet Journal. https://ejournal.unibabwi.ac.id/index.php/santhet/article/view/4808
Rahmawati, T. T. M. A., Nugroho, N. A., & Suwandono, A. (2024). Description of suspected suicide victims examined at Dr. Moewardi Surakarta Regional General Hospital from 2019 to 2023. Plexus Medical Journal, 3(3), 122–128. https://doi.org/10.20961/plexus.v3i3.1734
Ramadhan, A., & Sari, D. (2023). Forensic stylistic analysis on Per Ohlin’s suicide note. Jurnal Pendidikan Tambusai. https://jptam.org/index.php/jptam/article/view/11218
Sharma, B. R. (2022). Psychological autopsy: A way to revealing the enigma of equivocal death. International Journal of Forensic Sciences. https://medwinpublisher.org/index.php/IJFSC/article/view/8189
Singh, P., et al. (2025). Analysis of a rare case of complex suicide. Indian Journal of Psychiatry. https://doi.org/10.1177/09710973251411981
Siregar, A. N., et al. (2023). Forensic stylistic analysis on suicide note of a family in Malang. LingPoet Journal. https://idjpcr.usu.ac.id/lingpoet/article/view/16635
Tambunan, & Yudhianto. (2020). Toxicological examination in suicide cases involving hydrochloric acid and a review of medicolegal aspects. Indonesian Health Law Journal. https://jurnal-mhki.or.id/jhki/article/view/25
Tishler, C. L., & Reiss, N. S. (2023). Psychological autopsy: A powerful tool in forensic investigations. Forensic Sciences, 4(4), 44. https://www.mdpi.com/2673-6756/4/4/44
Wijaya, I. M. A., et al. (2023). Pathological findings from autopsies on suicidal vs homicidal hanging. Indonesian Journal of Legal and Forensic Sciences. https://jurnal.harianregional.com/ijlfs/id-75079
Yilmaz, A., et al. (2022). Psychological autopsy in completed suicide case. Middle East Medical Journal. https://dergipark.org.tr/en/pub/otd/issue/70294/1022534
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Mitjie Batsebha Sariwating
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share— copy and redistribute the material in any medium or format
- Adapt— remix, transform, and build upon the material for any purpose, even commercially.
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution— You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions— You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
- You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
- No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rightsmay limit how you use the material.
