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Are suicide deaths under-reported? Nationwide re-evaluations of 1800 deaths in Scandinavia.

Tøllefsen IM, Helweg-Larsen K, Thiblin I, Hem E, Kastrup MC, Nyberg U, Rogde S, Zahl PH, Østevold G, Ekeberg Ø - BMJ Open (2015)

Bottom Line: Valid mortality statistics are important for healthcare planning and research.The reclassification comprised an assessment of the manner and cause of death as well as the level of certainty.Hence, reclassification did not increase the overall official suicide statistics of the 3 Scandinavian countries.

View Article: PubMed Central - PubMed

Affiliation: Department of Acute Medicine, Oslo University Hospital Ullevaal, Oslo, Norway Faculty of Medicine, Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.

No MeSH data available.


Related in: MedlinePlus

Reclassifications of suicides in the Danish data set. Agreement (blue slanted lines) in classification of manner of death between the Danish Cause of Death Register and the experts’ classification. Bars to the left of the vertical black line show the experts’ reclassifications (%) from suicides to undetermined, natural deaths and accidents. Bars to the right of the vertical black line show the experts’ reclassifications (%) of accidents and natural deaths to suicides.
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BMJOPEN2015009120F4: Reclassifications of suicides in the Danish data set. Agreement (blue slanted lines) in classification of manner of death between the Danish Cause of Death Register and the experts’ classification. Bars to the left of the vertical black line show the experts’ reclassifications (%) from suicides to undetermined, natural deaths and accidents. Bars to the right of the vertical black line show the experts’ reclassifications (%) of accidents and natural deaths to suicides.

Mentions: In total, there was 90% (range 78–98%) agreement in the classification of suicides between the official mortality statistics and the experts’ reclassification (figure 4). In total, there was 8% (range 0–20%) disagreement between the official mortality statistics and the experts’ reclassification of suicides as undetermined manner of death. The Swedish and Danish psychiatrists each reclassified 13 (20% and 19%, respectively) cases registered as suicides in the Cause of Death Register as undetermined deaths. The other experts reclassified 0–5 (0–7%) suicides as undetermined deaths. None of the reported natural deaths in the Danish Cause of Death Register was reclassified as suicide, and 2.5% (range 0–7%) of the accidental deaths were reclassified as suicide. None of the experts reclassified any traffic accident deaths as suicides. Among the natural deaths, the Swedish forensic pathologist reclassified significantly more (p=0.046) of the ‘ill-defined and unknown causes of mortality’ (ICD-10: R96–R99) as undetermined deaths compared with the other cases of natural death. The other experts did not reclassify significantly more deaths in the ‘R96–R99-group’ as undetermined deaths compared with the other natural deaths.


Are suicide deaths under-reported? Nationwide re-evaluations of 1800 deaths in Scandinavia.

Tøllefsen IM, Helweg-Larsen K, Thiblin I, Hem E, Kastrup MC, Nyberg U, Rogde S, Zahl PH, Østevold G, Ekeberg Ø - BMJ Open (2015)

Reclassifications of suicides in the Danish data set. Agreement (blue slanted lines) in classification of manner of death between the Danish Cause of Death Register and the experts’ classification. Bars to the left of the vertical black line show the experts’ reclassifications (%) from suicides to undetermined, natural deaths and accidents. Bars to the right of the vertical black line show the experts’ reclassifications (%) of accidents and natural deaths to suicides.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663440&req=5

BMJOPEN2015009120F4: Reclassifications of suicides in the Danish data set. Agreement (blue slanted lines) in classification of manner of death between the Danish Cause of Death Register and the experts’ classification. Bars to the left of the vertical black line show the experts’ reclassifications (%) from suicides to undetermined, natural deaths and accidents. Bars to the right of the vertical black line show the experts’ reclassifications (%) of accidents and natural deaths to suicides.
Mentions: In total, there was 90% (range 78–98%) agreement in the classification of suicides between the official mortality statistics and the experts’ reclassification (figure 4). In total, there was 8% (range 0–20%) disagreement between the official mortality statistics and the experts’ reclassification of suicides as undetermined manner of death. The Swedish and Danish psychiatrists each reclassified 13 (20% and 19%, respectively) cases registered as suicides in the Cause of Death Register as undetermined deaths. The other experts reclassified 0–5 (0–7%) suicides as undetermined deaths. None of the reported natural deaths in the Danish Cause of Death Register was reclassified as suicide, and 2.5% (range 0–7%) of the accidental deaths were reclassified as suicide. None of the experts reclassified any traffic accident deaths as suicides. Among the natural deaths, the Swedish forensic pathologist reclassified significantly more (p=0.046) of the ‘ill-defined and unknown causes of mortality’ (ICD-10: R96–R99) as undetermined deaths compared with the other cases of natural death. The other experts did not reclassify significantly more deaths in the ‘R96–R99-group’ as undetermined deaths compared with the other natural deaths.

Bottom Line: Valid mortality statistics are important for healthcare planning and research.The reclassification comprised an assessment of the manner and cause of death as well as the level of certainty.Hence, reclassification did not increase the overall official suicide statistics of the 3 Scandinavian countries.

View Article: PubMed Central - PubMed

Affiliation: Department of Acute Medicine, Oslo University Hospital Ullevaal, Oslo, Norway Faculty of Medicine, Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.

No MeSH data available.


Related in: MedlinePlus