Toxicological Findings of Self-Poisoning Suicidal Deaths: A Systematic Review by Countries

May combine two claims.

Socio-cultural background and legislation influence rates and methods of suicide, leading to significant differences between countries.

“Socio-cultural background and legislation influence rates and methods of suicide. Therefore, significant differences can be observed between countries [6,11].”

• cites [6] Centers for Disease Control and Prevention (2022, July 09). Injury Prevention & Control, Available online: https://www.cdc.gov/injury/index.html.Not checked yet

  Not checked in the free run.

• cites [11] Mauri, 2005, Parasuicide and drug self-poisoning: Analysis of the epidemiological and clinical variables of the patients admitted to the Poisoning Treatment Centre (CAV), Niguarda General Hospital, Milan, Clin. Pract. Epidemiol. Ment. Heal. sourcePartly supported

  The Introduction (page unavailable) reports significant differences between European countries in the incidence of parasuicide. It does not attribute those differences to socio-cultural background or legislation, or report cross-country differences in suicide methods or completed-suicide rates. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Intentional self-poisoning is one of the most frequently used methods of committing suicide, along with using firearms and committing suicide by hanging.

“Intentional self-poisoning is one of the most frequently used methods of committing suicide, along with using firearms and committing suicide by hanging [12].”

• cites [12] Wu, 2012, Suicide Methods in Asia: Implications in Suicide Prevention, Int. J. Environ. Res. Public Health sourcePartly supported

  The Results (§3.1) and Discussion (§4.1) identify hanging and solid/liquid self-poisoning as dominant suicide methods in Asia. The Results also list firearms among common methods in a European study, but say firearms are not a leading method in most Asian countries studied. The source therefore does not support presenting all three as generally among the most frequently used methods without a geographic qualifier. (LLM, conf=0.84)

  Experimental — accuracy not yet measured

May combine two claims.

In South India, a retrospective study confirmed the use of mainly agricultural and industrial substances for suicidal purposes and identified family problems (30.2%), chronic illnesses (28.2%), financial problems (11%), and psychiatric problems (9.7%) as facilitating factors.

“In South India, a retrospective study [18] of 10 years of autopsy records of suicide by poisoning confirmed the previous data (i.e., the use of mainly agricultural and industrial substances for suicidal purposes) but also analyzed further factors facilitating suicide, such as family problems (30.2%), chronic illnesses (28.2%), financial problems (11%), psychiatric problems (9.7%), and others.”

• cites [18] Chaudhari, 2022, Epidemio-toxicological profile and reasons for fatal suicidal poisoning: A record-based study in South India, J. Fam. Med. Prim. Care sourcePartly supported

  Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

May combine two claims.

In India, Goswami et al. found that of 584 suspected poisoning deaths, 41.8% were poisoning and 86% of those were suicides.

“The retrospective study by Goswami et al. [20] examined autopsies of suspected deaths by poisoning. Of the 584 cases, 41.8% (244) were of poisoning, of which, 86% (210) were cases of suicide.”

• cites [20] Goswami, 2021, A Three-Year Study on Acute Poisoning Cases Brought for Medico-Legal Autopsy in a North-Eastern City of India, Open Access Emerg. Med. sourceSupported

May combine two claims.

In Portugal, of 304 autopsies, 97 cases (31.9%) were suicide by consuming poison, while 119 (39.1%) were suicide by hanging.

“A Portuguese retrospective study [32] on autopsies of 304 subjects found that 97 cases (31.9%) were of suicide by consuming poison, while 119 (39.1%) were of suicide by hanging.”

• cites [32] Dias, 2014, Suicides in the Centre of Portugal: Seven years analysis, Forensic Sci. Int. sourceSupported

May combine two claims.

In Iran, pesticides were involved in 84.2% of suicide by poisoning cases, followed by opiates (6.8%), methamphetamines (2.74%), ethanol (1.3%), strychnine (1.3%), and minor drugs.

“Toxicological examinations found that pesticides were involved in 84.2% of the cases, followed by opiates (6.8%), methamphetamines (2.74%), ethanol (1.3%), strychnine (1.3%), and minor drugs.”

• cites [26] Kordrostami, 2017, Forensic toxicology analysis of self-poisoning suicidal death in Tehran, Iran; trends between 2011–2015, DARU J. Pharm. Sci. sourcePartly supported

  Table 3 (Results > Forensic toxicology analysis results; page unavailable) lists detections that broadly match the quoted percentages when calculated against its total of 764 detections. But the paper investigated 674 self-poisoning deaths in Tehran during 2011–2015, and some cases involved multiple substances. The percentages therefore describe detections, not percentages of suicide-by-poisoning cases across Iran. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

May combine two claims.

Both unemployment and low educational levels are significant risk factors for suicide attempts.

“Both unemployment and low educational levels are significant risk factors for suicide attempts as they are associated with social drawbacks that may predispose an individual to suicidal behavior [49,56,57,58].”

• cites [49] Lang, 2021, Differences between suicide note leavers and other suicides: A German psychological autopsy study, J. Psychiatr. Res. sourceNot checked — no full text of the source
• cites [56] Schaffer, 2017, Self-poisoning suicide deaths in people with bipolar disorder: Characterizing a subgroup and identifying treatment patterns, Int. J. Bipolar. Disord. sourceCould not verify

  The Methods (Data source; page unavailable) list employment/financial stressors and past suicide attempts as separate variables, but do not identify unemployment as a risk factor for attempts. The Results (page unavailable) compare employment/financial stressors among groups of suicide decedents; they do not establish the claimed risk relationship. Searches for unemployment and educational attainment found no passage addressing the claim about low education. (LLM, conf=0.74)

  Experimental — accuracy not yet measured
• cites [57] Carlsten, 1999, Suicides by drug poisoning among the elderly in Sweden 1969–1996, Soc. Psychiatry Psichiatr. Epidemiol. sourceNot checked — no full text of the source
• cites [58] Kim, 2021, Predictive factors associated with methods of suicide: The Korean national investigations of suicide victims (the KNIGHTS study), Front. Psychiatry sourceCould not verify

  The Results section reports employment status in analyses of suicide methods, using unemployed people as the reference group; it does not establish unemployment as a risk factor for suicide attempts. A search for educational level found no passage addressing low education as a risk factor for attempts. The Discussion distinguishes suicide attempts from completed suicide but does not make the attributed claim (page numbers unavailable). (LLM, conf=0.76)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

In societies where basic needs of inhabitants, such as their emotional, financial, and religious needs, are addressed, suicide and its consequences rarely occur.

“In societies where basic needs of inhabitants, such as their emotional, financial, and religious needs, are addressed, suicide and its consequences rarely occur [48].”

• cites [48] Kasemy, Z.A., Sharif, A.F., Amin, S.A., Fayed, M.M., Desouky, D.E., Salama, A.A., Abo Shereda, H.M., and Abdel-Aaty, N.B. (2022). Trend and epidemiology of suicide attempts by self-poisoning among Egyptians. PLoS ONE. sourceSupported

May combine two claims.

The greater use of antidepressants than drug abuse is probably due to their greater availability and the progressive increase in the incidence of psychiatric pathologies and stress-related disorders.

“probably due to their greater availability and the progressive increase in the incidence of psychiatric pathologies and stress-related disorders [45,46].”

• cites [45] Cannizzaro, E., Ramaci, T., Cirrincione, L., and Plescia, F. (2019). Work-Related Stress, Physio-Pathological Mechanisms, and the Influence of Environmental Genetic Factors. Int. J. Environ. Res. Public Health, 16. sourcePartly supported

  The Introduction reports that financial crises may increase mental health disorders and substance abuse, which supports only the claim’s general link to rising psychiatric problems. It does not compare antidepressant use with drug abuse or attribute greater antidepressant use to availability or a progressive increase in stress-related disorders. The indexed copy provides no page number for the passage. (LLM, conf=0.78)

  Experimental — accuracy not yet measured
• cites [46] Cannizzaro, 2016, Behavioural and pharmacological characterization of a novel cannabinomimetic adamantane-derived indole, APICA, and considerations on the possible misuse as a psychotropic spice abuse, in C57bl/6J MICE, Forensic Sci. Int. sourceCould not verify

  The available indexed passages are an institutional repository listing, not the paper’s substantive text; the passage labeled Abstract lists keywords but no findings. Searches for antidepressant use, availability, and increasing psychiatric or stress-related disorders found no passage addressing the claim. The paper’s findings therefore cannot be assessed from the available copy. (LLM, conf=0.74)

  Experimental — accuracy not yet measured

May combine two claims.

The young age of victims correlates with their vulnerability and impulsiveness and their easy access to toxic drugs.

“The young age of the victims correlates with their vulnerability and impulsiveness and their easy access to toxic drugs [52,53].”

• cites [52] Mereish, 2019, Minority Stress and Relational Mechanisms of Suicide among Sexual Minorities: Subgroup Differences in the Associations between Heterosexist Victimization, Shame, Rejection Sensitivity, and Suicide Risk, Suicide Life-Threat. Behav. sourcePartly supported

  The Results section reports that participants at risk for suicide were about six years younger than those not at risk, supporting an association between younger age and suicide risk in this sexual-minority sample. It does not link younger age to impulsiveness or access to toxic drugs, or establish those as reasons for vulnerability. (LLM, conf=0.85)

  Experimental — accuracy not yet measured
• cites [53] Crosby, 2017, Suicide Trends Among and Within Urbanization Levels by Sex, Race/Ethnicity, Age Group, and Mechanism of Death—United States, 2001–2015, MMWR Surveill. Summ. sourceCould not verify

  The Results and Discussion (pages not provided) report suicide rates by age and mechanism, including drug poisoning, but do not link young age to vulnerability, impulsiveness, or access to toxic drugs. Searches for those proposed links found no passage addressing them. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

May combine two claims.

Depression and bad social conditions are related to a greater risk of suicide attempts.

“Depression and bad social conditions are related to a greater risk of suicide attempts, and family and social support is crucial to protection from suicide attempts.”

• cites [49] Lang, 2021, Differences between suicide note leavers and other suicides: A German psychological autopsy study, J. Psychiatr. Res. sourceNot checked — no full text of the source
• cites [56] Schaffer, 2017, Self-poisoning suicide deaths in people with bipolar disorder: Characterizing a subgroup and identifying treatment patterns, Int. J. Bipolar. Disord. sourceCould not verify

  The Results (page unavailable) list past suicide attempts and recent stressors among people who died by suicide, but do not test whether depression or adverse social conditions increase the risk of attempting suicide. Searches for depression, social conditions, and attempt risk found no passage making that association. (LLM, conf=0.75)

  Experimental — accuracy not yet measured
• cites [57] Carlsten, 1999, Suicides by drug poisoning among the elderly in Sweden 1969–1996, Soc. Psychiatry Psichiatr. Epidemiol. sourceNot checked — no full text of the source
• cites [58] Kim, 2021, Predictive factors associated with methods of suicide: The Korean national investigations of suicide victims (the KNIGHTS study), Front. Psychiatry sourcePartly supported

  The Discussion (page unavailable) states that depression is an independent risk factor for suicide. But the paper studies people who died by suicide and differences among suicide methods; it does not establish that depression or adverse social conditions increase the risk of suicide attempts. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Family and social support is crucial to protection from suicide attempts.

“Depression and bad social conditions are related to a greater risk of suicide attempts, and family and social support is crucial to protection from suicide attempts.”

• cites [49] Lang, 2021, Differences between suicide note leavers and other suicides: A German psychological autopsy study, J. Psychiatr. Res. sourceNot checked — no full text of the source
• cites [56] Schaffer, 2017, Self-poisoning suicide deaths in people with bipolar disorder: Characterizing a subgroup and identifying treatment patterns, Int. J. Bipolar. Disord. sourceCould not verify

  The Results table (page not provided) records interpersonal conflict or relationship breakup as a recent stressor among people who died by suicide. Our copy does not address whether family or social support protects against suicide attempts; searches for those terms found no passage establishing that claim. (LLM, conf=0.75)

  Experimental — accuracy not yet measured
• cites [57] Carlsten, 1999, Suicides by drug poisoning among the elderly in Sweden 1969–1996, Soc. Psychiatry Psichiatr. Epidemiol. sourceNot checked — no full text of the source
• cites [58] Kim, 2021, Predictive factors associated with methods of suicide: The Korean national investigations of suicide victims (the KNIGHTS study), Front. Psychiatry sourceCould not verify

  The Results (Demographic and Suicide Characteristics in Subjects; page unavailable) list family-related and interpersonal problems among recorded causes of suicide, but do not assess whether family or social support protects against suicide attempts. Searches for family support and social support found no passage establishing that claim; the study focuses on people who died by suicide and the methods they used. (LLM, conf=0.75)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

According to one selected study, the National Institute of Statistics in Spain argues that the number of suicides is higher in men than in women.

“According to one of the selected studies, the National Institute of Statistics in Spain argues that the number of suicides is higher in men than in women [55].”

• cites [55] Pires, 2014, Risk factors of suicide attempts by poisoning: Review, Trends Psychiatry Psychother. sourceCould not verify

  The Introduction discusses suicide deaths in Brazil and differences between men's and women's methods of suicide attempt, but does not report Spanish suicide counts by sex. Searches for Spain and its National Institute of Statistics found no passage attributing the claimed comparison to that agency. (LLM, conf=0.72)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

In most eastern European countries, poisoning is the third-leading cause of suicide death, after suicide by hanging and suicide by using firearms.

“In most eastern European countries, according to the WHO mortality database on methods of suicide [54], poisoning is the third-leading cause of suicide death, after suicide by hanging and suicide by using firearms.”

• cites [54] Weiss, 2008, Methods of suicide: International suicide patterns derived from the WHO mortality database, Bull. World Health Organ. sourcePartly supported

  The Results section identifies hanging as the predominant suicide method in eastern European countries. It does not establish the claimed ranking of firearms second and poisoning third; instead, it describes hanging in eastern and southern Europe as partly supplemented by pesticide poisoning. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

May combine two claims.

In many low-income countries in the Asia-Pacific region, suicide is the leading cause of death in early to middle adult life and pesticides account for around half to two-thirds of the suicides.

“In many low-income countries in the Asia-Pacific region, suicide is the leading cause of death in early to middle adult life and pesticides account for around half to two-thirds of the suicides.”

• cites [12] Wu, 2012, Suicide Methods in Asia: Implications in Suicide Prevention, Int. J. Environ. Res. Public Health sourcePartly supported

  The Introduction says suicide is one of the leading causes of death worldwide, and Results §3.1 identifies pesticide-related poisoning as the leading suicide method in China, Pakistan, and Sri Lanka. The paper does not establish that suicide is the leading cause of death in early to middle adulthood across many low-income Asia-Pacific countries, or that pesticides account for half to two-thirds of suicides there. The passages in our copy have no page numbers. (LLM, conf=0.85)

  Experimental — accuracy not yet measured
• cites [14] Spiller, 2020, Suicide attempts by self-poisoning in the United States among 10–25 year olds from 2000 to 2018: Substances used, temporal changes and demographics, Clin. Toxicol. sourceNot checked — no full text of the source

May combine two claims.

In Australia, an increasing trend of deaths due to intentional consumption of poison was observed, with a significant increase in medical prescription drugs, especially opioids, as in other high-income countries.

“In Australia, according to a recent study [50], an increasing trend of deaths due to intentional consumption of poison was observed, with a significant increase in medical prescription drugs, especially opioids, as in other high-income countries.”

• cites [50] Churruca, K., and Mitchell, R. (2018). Exploring coronial determination of intent for poisoning-related deaths in Australia, 2001–2013. BMC Public Health, 18. sourcePartly supported

  The Discussion reports significant increases in intentional pharmaceutical-poisoning mortality rates across Australia from 2001 to 2013, with decreases in New South Wales and Victoria. The Background links increased prescription-opioid use and misuse specifically to unintentional poisoning; the paper does not establish that opioids drove the increase in intentional deaths or that the same intentional-death trend occurred in other high-income countries. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

The WHO highlights that harmful use of alcohol and substance use disorders contribute to suicide ideation in all age groups.

“However, the WHO highlights that some risk factors, such as harmful use of alcohol and substance use disorders, contribute to suicide ideation in all age groups [14,53].”

• cites [14] Spiller, 2020, Suicide attempts by self-poisoning in the United States among 10–25 year olds from 2000 to 2018: Substances used, temporal changes and demographics, Clin. Toxicol. sourceNot checked — no full text of the source
• cites [53] Crosby, 2017, Suicide Trends Among and Within Urbanization Levels by Sex, Race/Ethnicity, Age Group, and Mechanism of Death—United States, 2001–2015, MMWR Surveill. Summ. sourceCould not verify

  The Introduction discusses influences on suicide, and the Discussion mentions drug overdoses and alcohol-related mortality alongside suicides. Neither passage says that harmful alcohol use or substance use disorders contribute to suicidal ideation in all age groups, or attributes that claim to the WHO. Searches for those risk factors and suicidal ideation found no supporting passage in our copy. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

May combine two claims.

The data of the selected studies are coherent with literature data and highlight that the characteristics of suicide by consuming poison show changing trends according to social and demographic factors.

“The data of the selected studies are coherent with literature data and highlight that the characteristics of suicide by consuming poison show changing trends according to social and demographic factors [52,61].”

• cites [52] Mereish, 2019, Minority Stress and Relational Mechanisms of Suicide among Sexual Minorities: Subgroup Differences in the Associations between Heterosexist Victimization, Shame, Rejection Sensitivity, and Suicide Risk, Suicide Life-Threat. Behav. sourcePartly supported

  The Results section, “Prevalence of and Sociodemographic Group Differences in Suicide Risk” (page unavailable), reports differences in suicide risk by age, gender, sexual orientation, income, education, and relationship status. But the paper measures suicide risk in a cross-sectional sample of sexual minorities; it does not establish changing trends over time or address suicide by consuming poison. (LLM, conf=0.86)

  Experimental — accuracy not yet measured
• cites [61] Carson, 2008, Classes of drugs and their prevalence in multiple drug intoxication in suicides and accidents, Leg. Med. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Of the included articles, 92% were retrospective studies.

“Of the articles, 92% were retrospective studies.”

May combine two claims.

In Sweden, Jonsson et al. found that 6966 (11.5%) of 60,313 autopsies were poison-related deaths and 44.3% were suicides.

“Jonsson et al. [39] studied the autopsies of 60,313 subjects from 1992 to 2002 and found that 6966 (11.5%) were poison-related deaths and 44.3% were suicides.”

• cites [39] Holmgren, 2004, Fatal intoxications in a Swedish forensic autopsy material during 1992–2002, Forensic Sci. Int. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The mean age was specified in 13 articles.

“The mean age was specified in 13 articles.”

May combine two claims.

The included articles comprised about 42% autopsy series on suicide, 29% autopsy series with no specific manner of death, 21% poisoning autopsies, and 8% self-poisoning suicide series.

“About 42% (10/24) of the included articles were autopsy series on suicide, about 29% (7/24) were autopsy series with no specific manner of death identified, about 21% of the articles (5/24) focused on autopsies in poisoning cases, and in 8% of the studies (2/24) only suicide by self-poisoning autopsy series were examined.”

May combine two claims.

In Sweden, ethanol was involved in 55% of cases, paracetamol in 21%, diazepam in 19%, morphine in a similar percentage, and minor antidepressants in a few cases.

“Toxicological analyses revealed that ethanol was involved in 55% of the cases, paracetamol in 21% of the cases, diazepam in 19% of the cases, morphine in a similar percentage of cases, and minor antidepressants in a few cases.”

• cites [27] Jones, 2016, Post-mortem concentrations of drugs determined in femoral blood in single-drug fatalities compared with multi-drug poisoning deaths, Forensic Sci. Int. sourceNot checked — no full text of the source

May combine two claims.

In Greece, drug abuse was found in 60% of cases and carbon monoxide in 19.8%; less than 10% of self-poisoning agents were pesticides, acids, and drugs.

“GC was used for toxicological investigations on blood and urine and revealed that there was drug abuse in 60%of the cases, and carbon monoxide was involved in 19.8% of the cases; less than 10% of the self-poisoning agents were pesticides, acids, and drugs.”

• cites [33] Boumba, 2013, Fatal Intoxications in a Forensic Autopsy Material from Epirus, Greece, During the Period 1998–2010, J. Forensic Sci. sourceNot checked — no full text of the source

May combine two claims.

In Finland, toxicological analysis showed 30.9% tested positive for benzodiazepines, 21.7% for alcohol, 16.3% for cocaine and methamphetamines, 9.2% for SSRIs, 8.3% for cannabinoids, 3.9% for NSAIDs, 2.9% for opiates, and 1.8% for methadone.

“On toxicological analysis, 30.9% of the subjects tested positive for benzodiazepines, 21.7% for alcohol, 16.3% for cocaine and methamphetamines, 9.2% for selective serotonin reuptake inhibitors, 8.3% for cannabinoids, 3.9% for non-steroidal anti-inflammatory drugs, 2.9% for opiates, and 1.8% for methadone.”

• cites [40] Lahti, 2003, Fatal drug poisonings: Medico-legal reports and mortality statistics, Forensic Sci. Int. sourceNot checked — no full text of the source

May combine two claims.

In Turkey, the primary mechanism of suicide was hanging (40.1%), followed by firearms (21.1%) and consumption of poison (19.7%).

“The primary mechanism of suicide was by hanging (40.1%), followed by the use of firearms (21.1%) and consumption of poison (19.7%).”

• cites [29] Azmak, 2006, Suicides in Trakya Region, Turkey, from 1984 to 2004, Med. Sci. Law sourceNot checked — no full text of the source

May combine two claims.

In Kentucky, Shieldz et al. analyzed 2864 suicide autopsies; 283 cases (9.9%) were related to poisoning, 393 (13.7%) to hanging, and 1932 (67.4%) to firearms.

“Shieldz et al. [38] conducted a retrospective study in Kentucky in the period 1993–2002 and analyzed 2864 autopsies related to cases of suicide where the average age of the victim was 59 years.”

• Also stated in: § 3.2. Analysis of Autopsies Related to Suicide by Poisoning · plain

  “Of the sample, 283 cases (9.9%) were related to poisoning, 393 (13.7%) cases to hanging, and 1932 (67.4%) cases to the use of firearms.”

• cites [38] Shields, 2006, A 10-Year Retrospective Review of Kentucky Medical Examiner Cases, Am. J. Forensic Med. Pathol. sourceNot checked — no full text of the source

May combine two claims.

In Norway, Frost et al. estimated that toxicological investigations were performed in 361 of 365 autopsies, and 2.4% involved suicide by poisoning.

“A study conducted between 2007 and 2009 by Frost et al. [34] in Norway estimated that toxicological investigations were performed in 361 of 365 autopsies.”

• Also stated in: § 3.2. Analysis of Autopsies Related to Suicide by Poisoning · plain

  “Of the total sample, 2.4% involved suicide by poisoning.”

• cites [34] Frost, 2012, Forensic autopsies in a naturalistic setting in Norway: Autopsy rates and toxicological findings, Forensic Sci. Int. sourceNot checked — no full text of the source

May combine two claims.

In Jamaica, 63.6% of poisoning-related deaths were suicides, committed by taking insecticides (41%), herbicides (paraquat 27%), drugs (48.9%), and cocaine (9%).

“A 20-year retrospective study [30] conducted in Jamaica on poisoning-related deaths revealed that 63.6% of these were suicides, committed by taking insecticides (41%), herbicides (paraquat 27%), drugs (48.9%), and cocaine (9%).”

• cites [30] Escoffery, 2004, Fatal Poisoning in Jamaica: A coroner’s autopsy study from the University Hospital of the West Indies, Med. Sci. Law sourceNot checked — no full text of the source

May combine two claims.

In France, toxicological blood tests showed benzodiazepines in 42.38% of cases, antidepressants in 31.68%, and neuroleptics and mood stabilizers in others.

“Toxicological blood tests showed that benzodiazepines were present in 42.38% of the cases, antidepressants in 31.68% of the cases, and neuroleptics and mood stabilizers in others.”

• cites [28] Franchi, 2016, Autopsy of People Having Committed Suicide in 2002 and in 2012: Comparison of Epidemiological and Sociological Data, J. Forensic Sci. sourceNot checked — no full text of the source

May combine two claims.

In Finland, Lahti et al. analyzed 500 autopsies where death was related to poison intake; 325 (65%) were suicides, 99 (19.8%) accidental, and 76 (15.2%) undetermined.

“A study published in 2003 by Lahti et al. [40] in Finland analyzed 500 autopsies conducted in 1997 where the mechanism of death was related to poison intake. Of these, 325 (65%) were cases of suicides, 99 (19.8%) were cases of accidental death, and 76 (15.2%) were undetermined.”

• cites [40] Lahti, 2003, Fatal drug poisonings: Medico-legal reports and mortality statistics, Forensic Sci. Int. sourceNot checked — no full text of the source

May combine two claims.

In Tunisia, toxicological examinations of self-poisoning suicides revealed medical drugs in 52.5%, pesticides in 42.6%, caustics in 4.4%, and butane gas in 0.5% of cases.

“Toxicological examinations revealed death by medical drugs (mainly psychotropics and cardiotropics) in 52.5% of the cases, pesticides in 42.6% of the cases, caustics in 4.4% of the cases, and butane gas in 0.5% of the cases.”

• cites [25] Gharbaoui, 2019, Pattern of suicide by self-poisoning in Northern Tunisia: An eleven-year study (2005–2015), J. Forensic Leg. Med. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

In the suicide autopsy series, consuming poison, hanging, and using firearms were the most common causes of death.

“In the suicide autopsy series, consuming poison, hanging, and using firearms were the most common causes of death.”

Probably not a substantial claim: may not pass S3 (load-bearing).

In 15 of the studies, the analytical technique performed was not specified.

“In 15 of the studies, the analytical technique performed was not specified.”

May combine two claims.

In all, there were 31,252 cases of poisoning, of which 14,276 involved suicide by poisoning and 6,844 were accidental death by poisoning.

“In all, there were 31,252 cases of poisoning, of which14,276 cases involved suicide by poisoning. There were 6844 cases of accidental death by poisoning.”

Probably not a substantial claim: may not pass S3 (load-bearing).

In 7 articles, the distribution of gender was not specified.

“In 7 articles, the distribution of gender was not specified.”

May combine two claims.

In Europe and Western countries, a lower pesticide incidence was observed, with higher rates of illicit drugs (especially opioids) and medically prescribed drugs (especially benzodiazepines, antidepressants, and neuroleptics) for suicide purposes.

“In Europe and Western countries, a lower pesticide incidence was observed, with higher rates of illicit drugs (especially opioids) and medically prescribed drugs (especially benzodiazepines, antidepressants, and neuroleptics) for suicide purposes.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The most frequent methodologies for the toxicological analysis were GC-MS, GC, and LC-MS (performed in 5 studies).

“The most frequent methodologies for the toxicological analysis were GC-MS, GC, and LC-MS (performed in 5 studies).”

May combine two claims.

In China, Wang et al. identified 140 cases of death by poisoning (7.11%) among 1968 autopsies, 27.8% of which were suicides.

“In a retrospective study of Wang et al. [24] conducted on 1968 autopsies, 140 cases of death by poisoning (7.11%) were identified, 27.8% of which were suicides.”

• cites [24] Wang, 2019, A retrospective study of poisoning deaths from forensic autopsy cases in northeast China (Lianoning), J. Forensic Leg. Med. sourceNot checked — no full text of the source

May combine two claims.

In Greece, of 1681 autopsies, 126 (7.49%) were poison-related deaths; there were 257 suicides (15.2%), of which 20 (16%) were suicides by poisoning.

“A study of 1681 autopsies performed in Greece [33] from 1998 to 2010 found 126 (7.49%) cases of poison-related deaths; the number of suicides was 257 (15.2%), and of these, 20 (16%) were suicides by poisoning.”

• cites [33] Boumba, 2013, Fatal Intoxications in a Forensic Autopsy Material from Epirus, Greece, During the Period 1998–2010, J. Forensic Sci. sourceNot checked — no full text of the source

May combine two claims.

In Turkey, victims who consumed poison had overdosed on single drugs or a mix of drugs in 51.8% of cases, pesticides in 37%, acids in 7.4%, and methanol in 0.7%.

“Toxicological investigations revealed that victims who had consumed poison had overdosed on single drugs or a mix of drugs in 51.8% of the cases, pesticides in 37% of the cases, acids in 7.4% of the cases, and methanol in 0.7% of the cases.”

• cites [29] Azmak, 2006, Suicides in Trakya Region, Turkey, from 1984 to 2004, Med. Sci. Law sourceNot checked — no full text of the source

May combine two claims.

In France, of 486 suicide autopsies, 19.5% were related to poisoning; most suicides were by hanging (30.86%).

“Of the486 suicide autopsies, 19.5% were related to poisoning; most suicides were by hanging (30.86%).”

• cites [28] Franchi, 2016, Autopsy of People Having Committed Suicide in 2002 and in 2012: Comparison of Epidemiological and Sociological Data, J. Forensic Sci. sourceNot checked — no full text of the source

May combine two claims.

In China, Pan et al. found that 13% of deaths were poisoning cases, of which 12.8% were suicides.

“In China, a retrospective study conducted on 299 autopsy cases by Pan et al. [23] showed that 13% (n = 39) of the deaths were poisoning cases, of which 12.8% (n = 5) were suicides.”

• cites [23] Pan, 2019, A retrospective analysis of data from forensic toxicology at the Academy of Forensic Science in 2017, Forensic Sci. Int. sourceNot checked — no full text of the source

May combine two claims.

There were no sufficient data on the type of suicide or the relationship between the kind of substance in self-poisoning and gender.

“however, there were no sufficient data on the type of suicide or the relationship between the kind of substance in case of self-poisoning and gender.”

May combine two claims.

In Kentucky, tests revealed antidepressants in 54.4% of cases, benzodiazepines in 29.2%, opioids in 37.4%, cannabinoids in 13.3%, and cocaine and related metabolites in 6%.

“Tests revealed the use of antidepressants in 54.4% of the cases, benzodiazepines in 29.2% of the cases, opioids in 37.4% of the cases, cannabinoids in 13.3% of the cases, and cocaine and related metabolites in 6% of the cases.”

• cites [38] Shields, 2006, A 10-Year Retrospective Review of Kentucky Medical Examiner Cases, Am. J. Forensic Med. Pathol. sourceNot checked — no full text of the source

May combine two claims.

Medical drugs are a common means of fatal poisoning, mostly in developed countries, with increased hospitalizations for poisoning by prescription opioids, sedatives, and tranquilizers.

“Medical drugs are also a common means of fatal poisoning, mostly in developed countries, with increased hospitalizations for poisoning by prescription opioids, sedatives, and tranquilizers.”

Classified as probably not a substantial claim.

The selected studies offer a snapshot of toxicological findings of autopsies in cases of suicide by self-poisoning worldwide.

“The selected studies offer a snapshot of toxicological findings of autopsies in cases of suicide by self-poisoning worldwide.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Poisoning is a relevant public health issue responsible for a considerable number of cases of morbidity and mortality worldwide, especially in low- and middle-income countries.

“Poisoning is a relevant public health issue responsible for a considerable number of cases of morbidity and mortality worldwide, especially in low- and middle-income countries [1].”

• cites [1] Andriessen, 2006, On “intention” in the Definition of Suicide, Suicide Life Threat. Behav. sourceNot checked — no full text of the source

May combine two claims.

Toxicological forensic diagnosis is extremely varied, with significant differences in laboratory capacities and technical developments across countries.

“However, toxicological forensic diagnosis is extremely varied, with significant differences in laboratory capacities and technical developments across countries [9,10].”

• cites [9] European Monitoring Centre for Drugs and Drug Addiction (2019). An Analysis of Post-Mortem Toxicology Practices in Drug-Related Death Cases in Europe, Technical Report, Publications Office of the European Union.Not checked yet

  Not checked in the free run.

• cites [10] Johnson, R., Wagner, R., and Gates, M. (2022, March 11). Forensic Toxicology Subcommittee, Available online: https://www.nist.gov/osac/forensic-toxicology-subcommittee.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Self-poisoning accounts for 25% of total suicides in the United Kingdom.

“Self-poisoning accounts for 25% of total suicides in the United Kingdom and is the most frequent method of committing suicide among the younger population in the U.S. [13,14].”

• cites [13] Kapur, 2005, Self-poisoning suicides in England: A multicentre study, QJM sourceNot checked — no full text of the source
• cites [14] Spiller, 2020, Suicide attempts by self-poisoning in the United States among 10–25 year olds from 2000 to 2018: Substances used, temporal changes and demographics, Clin. Toxicol. sourceNot checked — no full text of the source

May combine two claims.

Rates of suicide by consuming poison are higher in developing countries, especially suicide by consuming a pesticide.

“Rates of suicide by consuming poison are higher in developing countries, especially suicide by consuming a pesticide.”

• cites [15] Eddleston, 2000, Patterns and problems of deliberate self-poisoning in the developing world, QJM sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

In high-income countries, drugs used in attempts to commit suicide include psychotropic drugs, analgesics, antihistamines, antidepressants, psychoactive drugs, and sedative-hypnotics.

“In high-income countries, drugs used in attempts to commit suicide include psychotropic drugs, analgesics, antihistamines, antidepressants, psychoactive drugs, and sedative-hypnotics [15].”

• cites [15] Eddleston, 2000, Patterns and problems of deliberate self-poisoning in the developing world, QJM sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The quality of each study was evaluated independently by G.M. and G.D.A., with conflicts submitted to A.A.

“The quality of each study was evaluated independently by G.M. and G.D.A. If there was a conflict of opinions regarding the articles, they were submitted to A.A.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The protocol for this study was designed following PRISMA guidelines using the methodology described in the Cochrane Collaboration Handbook on Systematic Reviews of Health Promotion and Public Health Program.

“The protocol for this study was designed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [16] using the methodology described in the Cochrane Collaboration Handbook on Systematic Reviews of Health Promotion and Public Health Program [17].”

• cites [16] Stewart, 2015, Preferred Reporting Items for Systematic Review and Meta-Analysis of individual participant data: The PRISMA-IPD Statement, JAMA sourceNot checked — no full text of the source
• cites [17] Armstrong, 2005, It’s in your hands: The value of handsearching in conducting systematic reviews of public health interventions, Am. J. Public Health sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Psychological autopsy was developed in the United States and a few other countries (primarily Nordic) and introduced in France, including Lyon, in the 1990s.

“One of these is psychological autopsy, developed in the United States and a few other countries (primarily Nordic) and introduced in France, including Lyon, in the 1990s.”

• cites [28] Franchi, 2016, Autopsy of People Having Committed Suicide in 2002 and in 2012: Comparison of Epidemiological and Sociological Data, J. Forensic Sci. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

By collecting circumstantial and socio-psychological data, it is possible to identify the factors and preclude suicide.

“By collecting circumstantial and socio-psychological data, it is possible to identify the factors and preclude suicide.”

• cites [28] Franchi, 2016, Autopsy of People Having Committed Suicide in 2002 and in 2012: Comparison of Epidemiological and Sociological Data, J. Forensic Sci. sourceNot checked — no full text of the source

May combine two claims.

The findings are limited because only articles published in English were included and National data is often published locally.

“The findings are limited, given that only articles published in the English language were included and that National data is often published locally.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

In autopsy studies, it is hard to differentiate between medications taken for medical treatment as opposed to those taken only to commit suicide, especially in the case of medically prescribed drugs.

“Moreover, in autopsy studies, it is hard to differentiate between medications taken for medical treatment as opposed to those taken only to commit suicide, especially in the case of medically prescribed drugs.”

Probably not a substantial claim: may not pass S4 (based).

There is strong evidence that a reduction in the availability of the types of drugs used in suicide by drug poisoning might have a positive influence on reducing suicide rates.

“There is strong evidence that a reduction in the availability of the types of drugs used in suicide by drug poisoning might indeed have a positive influence on reducing suicide rates.”

May combine two claims.

Not all geographic areas are represented in the study and, given that the data emerge from autopsy studies, the results could not be representative of the epidemiological scenario.

“Moreover, not all geographic areas are represented in the study and given that the data emerge from autopsy studies, the results could not be representative of the epidemiological scenario.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Autopsy and toxicological analysis in suicide deaths are crucial for assessing the cause and manner of death and shed light on death by self-poisoning.

“Autopsy and toxicological analysis in suicide deaths are crucial for assessing the cause and manner of death and shed light on death by self-poisoning.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The results of the present study lack significant information about sociodemographic factors.

“In this regard, the results of the present study lack significant information about sociodemographic factors.”

May combine two claims.

The coroner's toxicology results focus on substances present at the moment of death and do not always gather information about chronic exposure to substances, medically prescribed drugs, or the source of ingestion.

“Moreover, the coroner’s toxicology results focus on substances present at the moment of death. They do not always gather information about chronic exposure to substances, medically prescribed drugs, or the source of ingestion.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

Autopsy and toxicological analyses are crucial to assess the manner of death by suicide and the substances consumed to commit suicide.

“Autopsy and toxicological analyses are crucial to assess the manner of death by suicide and the substances consumed to commit suicide.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Research on suicide methods is still inadequate, especially in some geographic areas.

“Research on suicide methods is still inadequate, especially in some geographic areas.”