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Klinik und Poliklinik für Psychiatrie und Psychotherapie der TU München, Klinikum rechts der Isar, Ismaningerstrasse 22, München, Germany. strubel@lrz.tu-muenchen.de
Unusual suicide attempts often remain undetected, and bizarre methods can be a clue to psychotic origin. We report a suicide attempt by proxy--the bite of a puff adder--and provide a brief literature survey about further archaic self-injurious behaviour. Due to the easy availability of venomous snakes and the close networking of suicidal patients via the Internet, an increase in similar cases can be anticipated. A failed suicide attempt should always be considered in patients surviving bizarre accidents.
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