Psychological factors in the determination of suicide in self-inflicted gunshot head wounds

Self-inflicted contact gunshot wounds to the head have usually been conside red presumptive of suicide. This study evaluates whether sufficient psychol ogical data are gathered in such cases to support a manner of death determi nation of suicide. We suggest that law enforcement agencies and coroner's d epartments do not fully explore the decedent's state of mind at the time of death. We studied the first 50 consecutive deaths in 1993 in a major metro politan county due to self-inflicted gunshot wounds to the head. The sample consists primarily of unmarried, white males, with a median age of 35 year s, who displayed psychiatric disturbance, primarily depression, before thei r death. Younger individuals were often under the influence of alcohol and/ or drugs at the time of death. Stressors, such as the loss of a loved one, are common among young and middle-aged persons, while serious health proble ms are found among the majority of middle-aged and elderly individuals. Man y of the findings of this study are consistent with the literature regardin g individuals who commit suicide. Although data on many important psycholog ical risk factors are missing in most cases, sufficient psychological mater ial is gathered about the decedent's mental condition at the time of death to support a suicide determination.