Survivors of Self-Inflicted Gunshot Wounds: A 20-Year Chart Review

Objective: Due to the small number of individuals who survive self-inflicted gunshot wounds (SIGSWs), little is known about this population. This study describes a sample of 497 survivors of SIGSWs, and examines patterns of demographics (gender, ethnicity, and age) and circumstances surrounding the incident (location of wound, intoxication, intentionality, and psychiatric diagnosis), which may bear on clinical work with this at-risk population. Method: We conducted a retrospective chart review of psychiatry consult records over a 20-year period from a community-based medical hospital with a trauma center. Of the 9,226 patients who had psychiatry consults from 1987 to 2007, 5% involved a SIGSW. A number of factors ascertained via clinical interview regarding demographics and circumstances were examined. Results: Several significant patterns emerged from the sample: (1) there was an overrepresentation of men compared with women; (2) African American survivors were younger and had a greater likelihood of being female compared with Caucasians; (3) male survivors shot themselves in the face/head/neck whereas the women shot themselves in the abdomen with more frequency; and (4) younger persons had a greater likelihood of being intoxicated at the time of the incident, initially claim the SIGSW was an accident, and receive a diagnosis of an adjustment disorder rather than a more serious depressive condition. Conclusions: This is the most comprehensive examination of SIGSW survivors conducted to date (to our knowledge). Given the usual lethality of SIGSWs, utilizing survivor data can provide critical insights, which may have implications for future research and clinical work with this vulnerable population. (Psychosomatics 2011; 52:34-40)