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O-24 - Declining Autopsy Rates and Suicide Misclassification: do we Have a Problem?

Published online by Cambridge University Press:  15 April 2020

N.D. Kapusta
Affiliation:
Psychoanalysis and Psychother, School of Psychology, Medical University of Vienna, Vienna, Austria
U.S. Tran
Affiliation:
Clinical, Biological and Differential Psychology, School of Psychology, Medical University of Vienna, Vienna, Austria
I.R. Rockett
Affiliation:
Medicine and Injury Control Research Center, West Virginia University, Morgantown, WV, USA
D. De Leo
Affiliation:
Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, and Life Promotion Clinic Mt Gravatt Campus, Griffith University, Queensland
C.P.E. Naylor
Affiliation:
Forensic and Scientific Services, Queensland Health, Clinical and Statewide Services Division, Archerfield, QLD, Australia
T. Niederkrotenthaler
Affiliation:
General Practice, Center of Public Health, Medical University of Vienna
M. Voracek
Affiliation:
Basic Psychological Research, School of Psychology, University of Vienna, Vienna, Austria
E. Etzersdorfer
Affiliation:
Furtbach Hospital for Psychiatry and Psychotherapy, Stuttgart, Germany
G. Sonneck
Affiliation:
Institute for Medical Psychology, Center of Public Health, Medical University of Vienna, Vienna, Austria

Abstract

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Suicides are prone to misclassification during death-ascertainment procedures. This problem has generated frequent criticism of the validity of suicide mortality statistics. The study aim was to employ an external measure of the validity of cause-of-death statistics, national autopsy rates, to examine potential misclassification of suicide across 35 countries. Data for the time period 1979–2007, were employed to analyze the association between suicide rates and autopsy rates and death rates of undetermined and ill-defined causes, respectively. Autopsy rates among nations were associated with suicide rates. These respective associations were robust with adjustment for unemployment, degree of urbanization, and the rate of undetermined or ill-defined deaths. Associations strengthened when analyses were confined to 19 EU member countries. Based on these results, we conclude that autopsy rates may impact the validity of suicide mortality statistics. Therefore, caution should be exercised in comparing international suicide rates and evaluating interventions that target suicide rate reduction.

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Copyright
Copyright © European Psychiatric Association 2012
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