Complex suicide versus complicated suicide.

In complex suicides, two or more methods are applied either simultaneously or one after the other. The purpose of the present study was to distinguish such complex suicides in the proper sense from "complicated suicides", which are characterized by an unintentional secondary traumatization following the original suicide method. The study material comprises 1217 suicides investigated at the Budapest Institute of Forensic Medicine in the period from 2004 to 2006. Among these, 4.43% (n=54) accounted for planned or unplanned complex suicides, whereas 0.49% (n=6) were categorized as "complicated suicides". The latter group included four fatalities due to unintended falls from a height (for instance after breaking of the hanging noose), one death from electrocution and one case of drowning. The succession of a failed suicidal act and a secondary ("unforeseen" and therefore "accidental") trauma with fatal outcome may cause problems in determining the manner and cause of death.