134 The American Journal of Forensic Medicine and Pathology 22(2):134–138, 2001. ©2001 Lippincott Williams & Wilkins, Inc., Philadelphia A retrospective study of cases of drowning suicide was undertaken at the Forensic Science Centre in Adelaide, South Australia for the period April 1980 to March 2000. A total of 123 cases were found, with 76 males (age, 16–88 years; average, 50.5 years; standard deviation [SD], 20.1 years) and 47 females (age, 34–88 years; av- erage, 60.6 years; SD, 13.9 years). There were 66 fresh water drownings and 57 saltwater drownings. Female victims were significantly older than male victims for both fresh water and saltwater drownings (P  .05 and P  .01, respectively). Deaths in young women were rare. No temporal trend in drowning suicides could be shown, with annual numbers varying from 0 to 12 cases (average, 6.15; median, 7). Women preferentially chose the ocean or bath to drown themselves in, whereas males chose rivers, ditches, and lakes. Swimming pools were rarely used for suicide in this population; alcohol use was not usual; and there was often a significant history of mental illness. Key Words: Drowning suicide—Mental illness. Although suicides by drowning account for a relatively low number of deaths in South Australia, cases may present diagnostic difficulties. This study was undertaken to analyze specific features of drowning suicides to determine whether partic- ular characteristics differed depending on the age and sex of the victim or the location of the drown- ing. MATERIALS AND METHODS The files of the Forensic Science Centre in Ade- laide, South Australia were examined for all cases listed as suicide by drowning during the 20-year period from April 1980 to March 2000. The Foren- sic Science Centre provides autopsy services to the State Coroner for the state of South Australia, Aus- tralia, which has a population of approximately 1.5 million persons. Cases had been designated as sui- cide only after full police investigations and foren- sic autopsies were undertaken. Equivocal cases were excluded from the study, and cases in which death may have been caused by an accident, natural disease, or homicide were also not included. Details of the year of death; age and sex of the victim; medical and psychiatric history; drug or al- cohol use; location of the drowning; and any addi- tional props or suicide techniques used were ex- tracted from the records and tabulated. Cases were divided into fresh water and saltwater drownings; fresh water drownings were subdivided further into bath, waterway (i.e., river, ditch, or lake), swim- ming pool, or miscellaneous groups. Saltwater drownings were subdivided into sea or beach; off jetties; inside cars; or miscellaneous groups. An “unknown” category was used when information was lacking. Statistical analyses were performed using the  2 and Student’s t test. Characteristic Features of Suicidal Drownings A 20-Year Study Roger W. Byard, M.D., Gillian Houldsworth, Ross A. James, F.R.C.P.A., and John D. Gilbert, F.R.C.P.A. Manuscript received June 1, 2000; accepted August 2, 2000. From the Forensic Science Centre, Adelaide, Australia. Address correspondence to Roger W. Byard, Forensic Sci- ence Centre, 21 Divett Place, Adelaide 5000, Australia; email: byardr01@forensic.sa.gov.au.