- 學位論文
臺北地方法院檢察署轄區2010至2014年上吊自殺案例分析
The Analysis of Suicide by Hanging in The Jurisdiction of Taipei District Prosecutors Office, 2010-2014
若您是本文的作者，可授權文章由華藝線上圖書館中協助推廣。
摘要
在臺灣上吊是一種常見且高致死率的自殺方式．本研究分析臺北地檢署轄區2010至2014年314件上吊自殺案件，以便了解此類案件的基本型態。評估變項包含了性別、年齡、婚姻狀況、教育程度、精神健康狀況、上吊地點、上吊使用材料、屍體姿勢型態、留有遺書與否、自殺過往史、自殺原因、屍體相驗外觀。結果呈現：男女上吊比例為1.6：1；在45-64歲年齡層，女性上吊比例（43.9%）高於男性（31.9%），在25-44歲年齡層，男性上吊比例（28.8%）反高於女性（21.1%）；女性有輕生念頭比例（69.9%）高於男性（56.5%）；女性有自殺過往史比例（37.4%）高於男性（22.5%）；上吊姿勢分為懸空82件(26.1%)，非懸空173件(55.1%)，不詳59件(18.8％) ；懸空與非懸空上吊姿勢比例為1:2.1；男性選擇戶外上吊比例（22.5%）遠高於女性（1.6%）；男性於浴室內自殺比例（3.7%）遠低於女性（17.9%）；女性使用絲巾、絲襪、布條或布繩比例明顯高於男性，而使用童軍繩或電線比例卻明顯低於男性；男女皆以繩結位於後枕部上方為最多；頸前水平沿耳後向上延伸呈現U型217件(69.1%)，頸前倒U3件(1%)；索溝位置在甲狀軟骨上方有267件(85%)；本研究遺留遺書比例為36%；精神疾病比例為46.2%；其中上吊司法解剖率為1.3%；毒物分析比例1.9%。至於上吊自殺原因以精神疾病/物質濫用所占比例最高(44.3%)，其次為生理疾病(20.4%)。最後，建議提高司法解剖率及毒物分析比例，並配合現場調查來決定死因及死亡方式。
並列摘要
Hanging is a common and highly lethal suicidal method in Taiwan. This study analyzed 314 suicides by hanging between 2010 and 2014 from the Jurisdiction of Taipei District Prosecutors Office, in order to understand the basic patterns for such cases. Assessment variables included gender, age, marital status, education, mental health, hanging place, use of tools, body posture patterns, leaving a suicide note or not, the past history of suicide, suicide reason, external appearance of inspected corpse. The results are as follows: Male to female ratio was 1.6:1. In the 45-64 age group, the proportion of hanging in female (43.9%) was higher than that in men (31.9%) , but in the 25-44 age group, the proportion of hanging in male (28.8%) was higher than that in female (21.1%). The proportion with presence of suicidal thoughts in female (69.9%) was higher than that in men (56.5%). Female has a higher proportion of suicide past history (37.4%) than male (22.5%). Commit suicide by hanging posture is divided into complete suspension 82 (26.1%), the incomplete suspension 173 (55.1%), and unknown posture 59 (18.8%). The hanging position ratio was 1:2.1. Male selection hanging outside ratio (22.5 %) was significantly higher than that of female (1.6 %). Male in bathroom suicide ratio (3.7%) was far below that of female (17.9 %). Female used scarves, stockings, or cloth roping ratio significantly higher than male, however the use of wire and Scout rope ratio was significantly lower than men. Both male and female with knots located above the occipital for most. The ligature runs from the midline above the thyroid cartilage symmetrically encircling the neck on both sides to the occipital region 217(69.9%).Hanging with point of suspension on front of neck has 3(1%). Ligature mark above the thyroid cartilage 267(85%).In this study revealed the proportion of leaving a suicide note , mental illness, forensic autopsy rate and toxic analysis would be 36%, 46.2%, 1.3% and 1.9%, represently. The cause of hanging related to mental illness / substance abuse occupied the highest proportion (44.3%), followed by physical illness (20.4%). Finally, we suggest that we have to promote the frequency of forensic autopsy and toxicological analysis , which are associated with the scene investigation to determine the cause and manner of death.
參考文獻
2. 高雄市自殺防治分析概況
13. 陳映燁、呂宗學、李馨如、郭千哲、邱震寰、陳喬琪, 臺灣與南韓方法別自殺率之比較. 北市醫學雜誌 2006:3(10):982-991.
22. 洪永泰,莊義利,陳怡如,翁文舜,劉季鑫,梁賡義,台灣地區鄉鎮市區發展類型應用於大型健康調查抽樣設計之研究.健康管理學刊.2006,4(1):1-22.
23. 蘇文棋,2013年度高雄地區自殺案件之分析研究.2015;台灣大學法醫學研究所.
5. Gunnell D, Bennewith O, Hawton K, Simkin S, Kapur N. The epidemiology and prevention of suicide by hanging: a systematic review.International Journal of Epidemiology. 2005;34:433–442