Kyparisia Karahalios¹, Hans H. de Boer^1,2, Judith Fronczek^1,2, Melanie Archer^1,2
1Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia; ²Victorian Institute of Forensic Medicine, Southbank, Victoria, Australia 

Deceased people are sometimes found in a state of undress, which may be context appropriate (e.g. sudden death during showering) or context inappropriate undressing (CIU). This can be attributed to ‘paradoxical undressing’ (PU) due to hypothermia, or may raise suspicion of sexual assault. However, it is unclear whether CIU is mostly PU, or whether it associates with other circumstances, or causes of death. To gain more insight into CIU, this study explored CIU demographics within Victorian Coronial cases, and examined whether it had any temperature, pathological, toxicological, or circumstantial associations. The case series included all Victorian deaths with CIU in 2022. Most cases were males over 55 years with a natural cause of death. Isolated lower garment removal was most prevalent in both sexes. A majority lived alone in homes often in disarray. Psychiatric conditions were common. No obvious relationship with temperature was observed. Hypothermia-associated features such as Wischnewski spots were rarely seen. CIU may therefore have contributory factors separate to its classical association with hypothermia. The high proportion of cases with comorbidities may suggest the possibility of secondary hypothermia or may indicate a more general association with confusion in the terminal phase of natural disease.