Objective: To describe a patient who survived a suicidal act in which lethal means were used and who subsequently cooperated with psychiatric examination.
Method: Case report.
Results: A 22-year-old man jumped from a bridge into the water 49 m below and survived. He was admitted to hospital for assessment. No psychiatric diagnosis could be made on either Axis I or II. He had misappropriated money and lost it gambling, and detection was imminent. He described his jumping as being the result of a sudden impulse. While he was falling he changed his mind and assumed an appropriate diving posture with the intention of preventing his death.
Conclusions: This is an example of a person performing a highly lethal suicide act, in the absence of Axis I or II disorder. Threat of disgrace and possible prosecution; and impulsivity were significant factors.