Suicide by unusual methods: a rare case of complex suicide

Bedanta Sarma, Senthil Kumaran M., Arun Kumar S., Shreemanta Kumar Dash


Genital Self-Mutilation (GSM) is usually associated with mental illness. It is considered as the most brutal form of self-harm. Many cases of such self-harm have been described by various authors in different times. However, its existence in absence of any mental illness and using it as a method of suicide is a matter of question. Although, some cases are reported; its incidence is very low. Its association with complex suicide is even much lower. Usually, in complex suicide, the victim chooses some methods which are less painful. Such a complicated case of complex suicide was brought to the tertiary care center of Dibrugarh, Assam for post mortem examination. The deceased, a 36 years old male was brought with history of cutting his external genitalia followed by hanging. The case has been described in this paper with relevant review literature.  


Genital self-mutilation, Mental illness, Complex suicide

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Paris J. Understanding self mutilation in borderline personality disorder. Harv Rev Psychiatry. 2005;13:179-85.

Satanly B, Gameroff MJ, Michalsen V, Mann JJ. Are suicide attempters who self-mutilate a unique population? Am J Psychiatry. 2001;158:427-32.

Baguelin-Pinaud A, Seguy C, Thibaut F. Self-mutilating behaviour: A study on 30 inpatients. Encephale. 2009;35:538-43.

Shoib S, Mushtaq R, Arif T, Hijaz SW. Self-mutilation of genitalia masquerading as suicide: A rare case report. J Psychiatry. 2014;17(115).

Rajasekharan C, Chandrasekharan. Klingsor Syndrome with obsessive compulsive disorder- A case report. University Journal of Medicine and Medical Specialities. 2019;5(7):1-3.

Moufid K, Joual A, Debbagh A, Bennani S, Elmrini M. Genital self mutilation. Prog Urol. 2004;14:540-3.

Bohus M, Limberger M, Ebner U, Glocker FX, Schwartz B, Wernz M et al. Pain perception during self reported distress and calmness in patients with borderline personality disorder and self mutiling behavior. Psychiatry Res. 2000;95:251-60.

Gilman SL. From psychiatric symptom to diagnostic category: Self-harm from the Victorians to DSM-5. Hist Psychiatry. 2013;24:148-65.

Nerli RB, Ravish IR, Amarkhed SS, Monoranjan UD, Prabha V, Koura A. Genital self mutilation in non psychotic heterosexual males: Case report of two cases. Indian J Psychiatry. 2008;50:285-7.

Schweitzer I, Aust NZ. Genital self-amputation and the Klingsor syndrome. J Psychiatry. 1990;24(4):566-9.

Eroglu MZ, Şahan E, Kıraz S. An unusual case of unplanned complex suicide. Psychiatry and Clinical Psychopharmacology. 2017;27(4):406-8.

Kesebir S, Gulpek D, Noyan MA. The nature of committing suicide. Anatolian J Psychiatry. 2002;3:88-96.

Shirodkar SS, Hammad FT, Qureshi NA. Male genital self-amputation in the Middle East: A simple repair by urethroplasty. Saudi Med J. 2007;28(5):791-3.

Greilsheimer H, Groves JE. Male genital self mutilation. Arch Gen Psychiatr. 1979;3694):441-6.

Nakaya M. On background factors of male self mutilation. Psychopathology. 1996;29:242-8.

Aboseif S, Gomez R, McAninch JW. Genital self mutilation. J Urol. 1993;150:1143-6.

Henry N, Henry B, Foong D, Filobbos G. Successful penile replantation after complete amputation and 23 hours ischaemia time: the first in reported literature. BMJ Case reports. 2020;13(6).

Ahsaini M, Tazi F, Khalouk A, Lahlaidi K, Bouazzaoui A, Stuurman-Wieringa RE et al. Bilateral testicular self-castration due to cannabis abuse: A case report. J Med Case Rep. 2011;5(404).

Withnal LA. Student home from university ‘cut off his own penis and stabbed his mother while high on mephedrone’. 2014. Available at: Accessed on 20 June 2021.

Tharoor H. A case of genital self-mutilation in an elderly man. J Clin Psychiatry. 2007;9(5):396-7.

Farmer R. Assessing the epidemiology of suicide and parasuicide. Br J Psychiatry. 1988;153(1):16-20.

Yang JG, Bullard MJ. Failed suicide or successful male genital self amputation? Am J Psychiatry. 1993;150(2):350-1.

Aalouane R, Rammouz I, Hafidi H, Boujraf S. Genital self-mutilation in an attempt of suicide by a patient with a borderline personality. J Neurosci Rural Pract. 2013;4(2):199-203.

Erkol Z, Sirin G, Erkol H, Yilmaz R, Ince H, Konuk N. Sub-total self amputation of the penis and bilateral self orchiectomy followed by suicide by hanging: Case report. Turkiye Klinikleri J Med Sci. 2012;32(3):869-73.

Eroğlu MZ, Guneş T, Nebioglu M. Suicide attempt by subcutaneous injection of cyanide: a case report. Düşünen Adam. J Psychiatry Neurol Sci. 2014;3:257-60.