Format

Send to

Choose Destination
BMJ Open. 2015 Nov 25;5(11):e009120. doi: 10.1136/bmjopen-2015-009120.

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

Author information

1
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.
2
Department of Social Medicine and Public Health Research, Copenhagen University, Copenhagen, Denmark.
3
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
4
Faculty of Medicine, Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway Division of Mental Health and Addiction, Oslo University Hospital Ullevaal, Oslo, Norway.
5
Amalievej 23, Frederiksberg, Denmark.
6
Department of Clinical Neuroscience, Stockholm Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden.
7
Norwegian Institute of Public Health, Oslo, Norway Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
8
Norwegian Institute of Public Health, Oslo, Norway.

Abstract

OBJECTIVE:

Valid mortality statistics are important for healthcare planning and research. Suicides and accidents often present a challenge in the classification of the manner of death. The aim of this study was to analyse the reliability of the national suicide statistics by comparing the classification of suicide in the Scandinavian cause of death registers with a reclassification by 8 persons with different medical expertise (psychiatry, forensic pathology and public health) from each of the 3 Scandinavian countries.

METHODS:

The cause of death registers in Norway, Sweden and Denmark retrieved available information on a sample of 600 deaths in 2008 from each country. 200 were classified in the registers as suicides, 200 as accidents or undetermined and 200 as natural deaths. The reclassification comprised an assessment of the manner and cause of death as well as the level of certainty.

RESULTS:

In total, 81%, 88% and 90% of deaths registered as suicide in the official mortality statistics were confirmed by experts using the Swedish, Norwegian and Danish data sets, respectively. About 3% of deaths classified as accidents or natural deaths in the cause of death registers were reclassified as suicides. However, after a second reclassification based on additional information, 9% of the natural deaths and accidents were reclassified as suicides in the Norwegian data set, and 21% of the undetermined deaths were reclassified as suicides in the Swedish data set. In total, the levels of certainty of the experts were 87% of suicides in the Norwegian data set, 77% in the Swedish data set and 92% in Danish data set; the uncertainty was highest in poisoning suicides.

CONCLUSIONS:

A high percentage of reported suicides were confirmed as being suicides. Few accidents and natural deaths were reclassified as suicides. Hence, reclassification did not increase the overall official suicide statistics of the 3 Scandinavian countries.

KEYWORDS:

PUBLIC HEALTH

PMID:
26608638
PMCID:
PMC4663440
DOI:
10.1136/bmjopen-2015-009120
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center