|Year : 2013 | Volume
| Issue : 1 | Page : 49-51
Multifactorial analysis of hanging deaths
Kh Pradipkumar Singh, Aelifeter R Marak, Th Meera
Department of Forensic Medicine, Regional Institute of Medical Sciences, Imphal, Manipur, India
|Date of Web Publication||17-Aug-2013|
Department of Forensic Medicine, Regional Institute of Medical Sciences, Imphal - 795 004
Source of Support: None, Conflict of Interest: None
Objective: The objective of this study was to analyze hanging deaths occurring in Imphal in relation to several factors associated with such deaths. Materials and Methods: This study was performed on 35 cases of hanging deaths brought for an autopsy to the mortuary of Regional Institute of Medical Sciences, Imphal. Factors associated with these deaths and post-mortem findings were recorded and statistically analyzed. Observation: It was observed that the most vulnerable age group was 21-30 years in both sexes. Nearly, 51.42% of the cases belonged to the lower socio-economic group; and the majority of the female victims were house wives (34.29%) who were going through marital disharmony. 82.86% of suicides by hanging occurred indoors and the bedroom was the preferred site in 18 cases (51.42%). The commonly used ligature materials were means which were easily available to the victim viz. nylon rope, chunni, etc. Petechial hemorrhage on the face and eyes were observed in partial hanging cases only. Conclusion: The findings of the present study will help in highlighting the prevailing scenario of hanging deaths in this state.
Keywords: Hanging, Ligature material, Petechial hemorrhage, Pre-disposing factor, Types
|How to cite this article:|
Singh KP, Marak AR, Meera T. Multifactorial analysis of hanging deaths. J Med Soc 2013;27:49-51
| Introduction|| |
Hanging (self-suspension) is that form of asphyxia, which is caused by suspension of the body by a ligature, which encircles the neck, the constricting force being the weight of the body. The whole weight of the body is not necessary, and only a comparatively slight force is enough to produce death. Hanging remains to be one of the common methods of committing suicide. Internationally, death by hanging ranks among the most common method of suicide accounting for more than 50% of all suicides in Saudi Arabia and Hungary while in Norway and Denmark it falls to second place with a frequency of 25% and 17% respectively.  In India, according to National Crime Bureau Report in 2009,  hanging constitutes 31.5% of suicide and a large number of victims who committed suicide by hanging were reported from Arunachal Pradesh (103 people), Dadar and Haveli (40), Andaman and Nicobar Island (106) and Sikkim (148).
| Materials and Methods|| |
The study was performed in the mortuary of Regional Institute of Medical Sciences, Imphal on 35 cases of hanging deaths brought for autopsy during the previous 2 years. After recording the history and findings of crime scene from the police, relatives and eye witnesses, a meticulous post-mortem examination was conducted. Factors associated with these deaths and post-mortem findings were recorded and statistically analyzed.
| Results|| |
Out of the 35 cases, the highest number of cases belonged to the age group of 21 to 30 years and no cases occurred below the age of 10 years. No significant differences in the incidence of hanging among males and females in different age groups could be observed [Table 1].
A total of 51.42% of the cases belonged to the lower socio-economic group while 48.58% belonged to the middle socio-economic group of the society. 34.29% of the cases were housewives followed by students (17.14%) as shown in [Table 2] and [Table 3]. Marital disharmony, especially in females (31.43%), followed by disappointment in love (20%) were found to be the most common predisposing factors for suicide by hanging. In males, financial problem was found to be the most common factor. Among the security personnel, denial of leave was the major cause of suicidal hanging accounting for 80% [Table 3] and [Table 4]. As shown in [Table 5], 82.86% of the suicides by hanging occurred indoors while the remaining occurred at outdoor locations and bedroom was the preferred site in both the sexes (51.42%).
A total of 28.58% of the cases used nylon ropes while another 22.86% used "dupatta/chunni" as ligature material [Table 6]. Complete hanging was seen in 68.57% while the partial hanging was seen in the remaining [Table 7]. A significant difference in the presence of petechial hemorrhage on the face and eyes could be observed between complete and partial hanging cases [Table 8].
| Discussion|| |
In the present work, no significant difference in the incidence of male and female victims could be observed. This finding differs from those of workers like Singh et al.  Lalwani et al.  and Azmak.  This could reflect a changing scenario in the sex ratio of hanging deaths.
Several workers ,, have observed that the highest number of victims of hanging belonged to the age group of 21-30 years followed by 31-40 years. Similar findings were observed in this study where maximum numbers of cases were in the age range of 21-30 years (43.33%) and 31-40 years (26.67%). This could be explained by the fact that the age group of 21-40 years is the most active phase in life wherein exposure to anxiety, stress, strain, and various adverse circumstances occur. From the present study, it is evident that the most common victims were from lower socio-economic group. This reflects difficulties, adverse circumstances and level of frustration in competitive youngsters belonging to the underprivileged section of the society.
In this series, maximum number of the hanging cases (82.86%) occurred indoors. This may be compared to the findings of Shaw et al.  who observed that most of the suicides (61%) occurred indoors. Likewise, Rauji and Dogra  were of the opinion that 96% of the victims were found in surroundings familiar to them. This holds true in the present study as majority of the cases were found inside their bedrooms.
In a study by Naulchaem,  it was observed that main motivation was psychological and mental illness in deaths due to suicidal hanging. Interestingly, in the present series, the main predisposing factors were marital disharmony in females and financial problems in males. On the other hand, out of the five cases of suicidal hanging amongst security personnel, four were due to denial of leave (80%). Home sickness, denial of leave, and frustration often push these security personnel to depression. Hence, regular monitoring of their anxiety levels by the concerned authority will help in containing the problem to a certain extent.
In a study by Fimate et al.  ligature materials commonly used were jute ropes (52.1%) followed by nylon rope (35.8%), cloth (9.4%), etc. On the other hand, Sharma et al.  also observed that chunni (30.9%) was the most common ligature material used followed by nylon rope (18.8%). Similar findings were observed in the present study and these ligature materials were means, which were easily available to the victim at the material moment.
Petechia, one of the classic signs of asphyxia, are thought to be more frequently observed in cases of hanging where part of the body is supporting the victim's weight that is cases of incomplete (partial) hanging.  Circumstances affording reduced ligature pressure to the neck and less arterial compromise like partial hanging might be expected to result in increased levels of intravascular pressure and more frequent petechia. Hence, the presence of facial/periorbital petechial hemorrhages directly correlates with the degree of body support below the point of ligature attachment.  Similarly, in the present study, petechial hemorrhage on the face and eyes could be observed only in partial hanging cases and this finding is of importance in differentiating complete from partial hanging cases.
| Conclusion|| |
Hanging is a common means of suicide among younger people belonging to the lower socio-economic group of the society, and is usually committed in familiar surroundings with ligature materials easily available to the victim. Marital disharmony is a common predisposing factor of suicide in women. However, among the security personnel, denial of leave is a major contributory factor for suicide, which calls for regular monitoring of their anxiety levels. Hence, the findings of the present study will help in highlighting the prevailing scenario of hanging deaths in this state.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8]