KOTA KINABALU: Zara Qairina Mahathir's manner of death is most consistent with suicide based on a psychological autopsy, the Coroner's Court heard today.
Consultant forensic psychiatrist Dr Chua Sze Hung, 43, said the assessment found the 13-year-old had more suicide risk factors than protective factors at the time of the incident.
The 67th witness said he had prepared, signed and stamped an 84-page psychiatric report dated Feb 2, focusing on the probability of suicide and the circumstances surrounding the case.
He said the assessment reviewed multiple sources, including Zara's diaries, the scene, a post-mortem report by consultant forensic pathologist Dr Jessie Hiu, counselling records, visits to her hostel and dormitory, and interviews with family members, school staff at SMKA Tun Datu Mustapha, and her primary school.
"There is information suggestive of emotional dysregulation, intense anger, self-harming behaviour, unstable interpersonal relationships and fear of abandonment. However, it is insufficient to form a diagnosis of personality disorder retrospectively.
"While there are indications of depressive symptoms, I do not believe that the deceased was suffering from a diagnosable severe mental illness prior to the incident.
"The convergence of predisposing and precipitating factors suggests the final act likely occurred during a state of overwhelming acute distress, impaired judgment, and reduced access to normal protective mechanisms, rather than a meticulously planned act," he said when reading his witness statement before Coroner Amir Shah Amir Hassan.
Dr Chua said suicide is among the leading causes of death among older adolescents, noting that many cases involve individuals without a prior documented mental health diagnosis.
He added that studies show Malaysian adolescents aged 13 to 15 are at higher risk of suicide attempts, particularly among those experiencing parental separation.
"In this case, predisposing factors include stressful life events, negative self-perception, perceived bullying, unsatisfactory academic performance, substance use history, verbal aggression, non-suicidal self-injury, parental separation, conflict with parents, social sensitivity, depressive symptoms, conduct issues and expressions of wanting to die.
"Precipitating factors include a stressful life event described as an interrogation and a sense of isolation. Other contributing circumstances include chronic sleep deprivation and disappointment following a prefect's reminder," he said.
He said several risk factors were present even before Zara entered SMKA Tun Datu Mustapha.
The Sabah Attorney-General's Chambers had on Sept 17 requested the Health Ministry to conduct a psychiatric assessment to assist in the inquest.
A three-member team comprising Dr Chua, child and adolescent psychiatrist Dr Nurulwafa Hussain, and clinical psychologist Norhameza Ahmad Badruddin was appointed by the Health director-general on Sept 19, 2025, to carry out the assessment using a psychological autopsy approach.
Dr Chua said he has previously testified as an expert witness in homicide, drug trafficking and sexual offence cases under Section 342 of the Criminal Procedure Code in courts nationwide.
Zara, 13, was found unconscious on the ground floor of her hostel and was pronounced dead on July 17, 2025, at Hospital Queen Elizabeth. - NST
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