Wang Li-Jun, Phillips Michael, Huang Zheng-Jing, Zhang Yan-Ping, Zhao Yun-Xia, Yang Gong-Huan
Chinese Centers for Disease Prevention and Control, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2003 Oct;24(10):889-92.
To evaluate the accuracy of reports of suicide in the national death registry systems and to estimate a more accurate suicide rate.
Twenty-three sites from the Disease Surveillance Points Network-one of the national death registry systems-were selected and 1 932 of the deaths that occurred at these sites from August 1995 through August 2000 in which the official cause was classified as "accidental" or "mental illness" were selected for detailed household surveys focusing on reassessing the cause of death. Valid interviews were completed in 1 653 of these cases. The original cause of death recorded on the death certificate was compared with the finding of the detailed household survey and the result was used to adjust the suicide rate.
After detailed investigation, 16 of the 857 (1.87%) deaths reported on the death certificate as suicide were considered accidental deaths, 39 of the 721 (5.41%) accidental deaths were considered suicide, 17 of the 35 (48.57%) cases reported as undetermined accidents were considered suicide, and 6 of the 40 (15.00%) cases in which mental illness was the recorded cause of death were considered suicide. After adjustments for errors in the reported cause of death and for missing deaths, the reported crude suicide rate of 13.65/100 000 in China was adjusted to 22.99/100 000 (95% CI: 21.78/100 000 - 24.25/100 000).
After adjustments the actual suicide rate for China was higher than the reported rate indicating that suicide was an increasingly important public health problem for China.
评估国家死亡登记系统中自杀报告的准确性,并估算更准确的自杀率。
从疾病监测点网络(国家死亡登记系统之一)选取了23个地点,并选取了1995年8月至2000年8月在这些地点发生的1932例死亡病例,这些病例的官方死因被归类为“意外”或“精神疾病”,针对重新评估死因开展了详细的家庭调查。其中1653例完成了有效的访谈。将死亡证明上记录的原始死因与详细家庭调查的结果进行比较,并将结果用于调整自杀率。
经过详细调查,死亡证明上报为自杀的857例死亡病例中有16例(1.87%)被认为是意外死亡,721例意外死亡中有39例(5.41%)被认为是自杀,报告为不明原因意外的35例病例中有17例(48.57%)被认为是自杀,记录死因是精神疾病的40例病例中有6例(15.00%)被认为是自杀。在对报告死因的错误和漏报死亡进行调整后,中国报告的粗自杀率13.65/10万调整为22.99/10万(95%可信区间:21.78/10万 - 24.25/10万)。
调整后中国的实际自杀率高于报告率,表明自杀是中国一个日益重要的公共卫生问题。