an atypical suicide attempt: self-inflicted intra-cardiac injury with sewing needle

atypical cases of suicide are less likely to be seen in general hospitals, nonetheless require further investigation into the precipitating factors as well as proper follow-up. this paper illustrates a 61-year-old woman with major depressive disorder who experienced auditory hallucinations during delirious periods of taking low-dose benzodiazepines, who referred to the hospital with a sewing needle stuck in her chest wall. the needle was successfully removed. psychiatric problems are often underdiagnosed, therefore undertreated in general hospitals. thus close monitoring of the patients during the hospitalization and after discharge is crucial.