Aim. To analyze diagnostic and surgical tactics for suicidal and autoaggressive thoracic and abdominal lesions. Material and methods. We have analyzed the features of emergency surgical care depending on type of patients’ behavior at admission. There were 516 patients with suicidal and autoaggressive thoracic and abdominal lesions. Results and discussion. Depressive (34%) and adequate (46%) patients were examined routinely. Inadequate (aggressive) behavior is inappropriate for instrumental examination while medical sedation may be followed by significant hemodynamic disorders in patients with severe lesions. It was noted that indications for explorative surgery should be expanded in these patients and administration of sedatives should be combined with induction of general anesthesia. Conclusion. Severity of trauma and type of surgery affect mental state dynamics while the kind of psychopathy influences postoperative period course.