A singular case of asphyxia by choking on a handkerchief: accidental event or suicide to "shut-up" spirits

[Evolution of views on the phenomenon of spiritual possession within the framework of psychiatric pathology (psychopathological, transnosological and transcultural aspects)]

The spiritual possession phenomenon (SPP), is a complex transnosological, transcultural syndrome, which is based on the patients' perception that some spiritual entity (spirit, demon, jinn, shaitan, «ikotka», dybbuk, Buddha, etc.) is influencing or possessing them. Modern classifications of diseases, aimed at expanding our ideas about the distinction between the norm and pathology of mental disorders, do not contribute to a clear psychopathological differentiation of SPP, the determination of its nosological affiliation and the choice of appropriate therapeutic tactics for these conditions. To date, there is no unity of ideas about SPP among psychiatrists, and the conflict between different interpretations of the phenomenon persists. The aim of this review was to analyze scientific studies devoted to the SPP within the framework of psychiatric pathology in mature age patients, in order to differentiate the underlying psychopathological disorders, to determine the nosological affiliation and the specific therapeutic approaches of these conditions. The keywords «mental disorder spirit possession», «possession dissociative identity disorder», «delusion of possession» were searched in the electronic databases eLibrary and PubMed, as well as in the Russian State Library and the scientific library of the Mental Health Research Center, publications of Russian and foreign researchers for the period from the 3s of the XIX century to the present time were selected and analyzed. The dynamics of psychiatric views on the SPP within the framework of mental disorders over time was assessed. The study of the SPP remains a challenging multidisciplinary problem for contemporary scientific research. The SPP requires further deep interdisciplinary understanding, detailed clinical and psychopathological analysis and final determination of its place in clinical psychiatry.

Forensic appraisal of death due to acute alcohol poisoning: three case reports and a literature review

Death due to acute alcohol poisoning lacks specific anatomical characteristics, compared with other deaths due to drug poisoning. We report three forensic cases of death from acute alcohol poisoning due to inhibition of the respiratory centre and eventual asphyxia. Blood alcohol concentrations in the three fatalities were 5.28, 3.33 and 3.78 mg/mL, respectively. Lethal doses and blood alcohol concentrations showed differences between individuals. Detailed auxiliary tests besides autopsy were undertaken. These cases show that forensic scientists should exclude other causes of death, combine the autopsy with auxiliary tests, and then make an appraisal.