Journal List > Korean J Leg Med > v.43(1) > 1117335

Kim and Lee: Extreme Suicide


Many people end their lives by committing suicide every year. Most of these people inflict their own death using a method that is considered least painful such as hanging, gun shots, and drug overdose. Some choose to use their surroundings and jump off high buildings. We here present two cases of extremely rare suicide methods compared to the typically observed self-inflicted deaths. In the first case, a woman amputated her foot above the ankle with a kitchen knife, and in the second case, a man used an abrasive saw to cut his neck. Both victims had a psychiatric problem consistent with schizophrenia. Examination of these extraordinary death cases warrants a thorough scene investigation and an autopsy to determine past and present psychiatric illnesses and drug prescriptions.

Figures and Tables

Fig. 1

(A) The victim was discovered lying dead in the bathtub. Her foot was cut off above the ankle following several incision wounds. The kitchen knife was found on the side of the bathtub near the faucet. (B) The left foot was cut off above the ankle. The cut wound showed irregular edges. Several superficial incision wounds (hesitation wounds) can be seen.

Fig. 2

(A) The victim was found lying dead in a pool of blood near a small table on which an abrasive saw had been fixed. A suicide note was found beside the glasses on the right table. (B) The left side of the neck shows a large incision wound with jagged edges and a wide abrasion in the center. The left common carotid artery was severed in the wound cavity.



Conflicts of Interest No potential conflict of interest relevant to this article was reported.


1. Silverstein SM, Del Pozzo J, Roché M, et al. Schizophrenia and violence: realities and recommendations. Crim Psychol Rev. 2015; 1:21–42.
2. Supreme Public Prosecutor's Office. 2018 Analytical statistics on crime [Internet]. Seoul: Prosecution Service;2018. cited 2019 Jan 3. Available from:
3. Sartorius N, Jablensky A, Korten A, et al. Early manifestations and first-contact incidence of schizophrenia in different cultures: a preliminary report on the initial evaluation phase of the WHO Collaborative Study on determinants of outcome of severe mental disorders. Psychol Med. 1986; 16:909–928.
4. Bleuler E. Demential praecox or the group of schizophrenias. New York: International Universities Press;1950. p. 488.
5. Karvonen K, Sammela HL, Rahikkala H, et al. Sex, timing, and depression among suicide victims with schizophrenia. Compr Psychiatry. 2007; 48:319–322.
crossref pmid
6. Perenyi A, Forlano R. Suicide in schizophrenia. Neuropsychopharmacol Hung. 2005; 7:107–117.
7. Lonnqvist JK, Henriksson MM, Isometsa ET, et al. Mental disorders and suicide prevention. Psychiatry Clin Neurosci. 1995; 49:Suppl 1. S111–S116.
8. Shields LB, Hunsaker DM, Hunsaker JC 3rd. Schizophrenia and suicide: a 10-year review of Kentucky medical examiner cases. J Forensic Sci. 2007; 52:930–937.
crossref pmid
9. Kreyenbuhl JA, Kelly DL, Conley RR. Circumstances of suicide among individuals with schizophrenia. Schizophr Res. 2002; 58:253–261.
crossref pmid
10. Lim LC, Tsoi WF. Suicide and schizophrenia in Singapore: a fifteen year follow-up study. Ann Acad Med Singapore. 1991; 20:201–203.
11. Onyeka IN, Beynon CM, Vohlonen I, et al. Potential years of life lost due to premature mortality among treatment-seeking illicit drug users in finland. J Community Health. 2015; 40:1099–1106.
crossref pmid
12. Lapatto-Reiniluoto O, Vuori E, Hoppu K, et al. Fatal poisonings in Finland during the years 2004-2009. Hum Exp Toxicol. 2013; 32:600–605.
13. Harkavy-Friedman JM, Kimhy D, Nelson EA, et al. Suicide attempts in schizophrenia: the role of command auditory hallucinations for suicide. J Clin Psychiatry. 2003; 64:871–874.
14. Farberow NL, Shneidman ES, Leonard CV. Suicide among schizophrenic mental hospital patients. In : Farberow NL, Shneidman ES, editors. The cry for help. New York: McGraw-Hill Book Company;1961. p. 78–109.

Dae Yoil Kim

SangHan Lee

Similar articles