Goldacre Michael J, Duncan Marie E, Griffith Myfanwy, Cook-Mozaffari Paula
Unit of Health-Care Epidemiology, Dept. of Public Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK.
Soc Psychiatry Psychiatr Epidemiol. 2006 May;41(5):409-14. doi: 10.1007/s00127-006-0035-5. Epub 2006 Feb 8.
Psychiatric disorders are sometimes certified on death certificates, but seldom selected as the underlying cause of death. The majority of deaths with a certified psychiatric cause are usually omitted from official mortality statistics, which are typically based on the underlying cause alone.
To report on death rates for psychiatric disorders, as certified on death certificates, including all mentioned causes as well as the underlying cause of death.
Analysis of database including all certified causes of death in 1979-1999, in three time periods defined by coding rule changes.
Statistics on the underlying cause of death grossly under-estimated certified psychiatric disorders. For example, in the first period of our study they missed 88% of deaths in which schizophrenia was a certified cause, 98% of affective psychosis, and 96% of depression. Over time, considering all certified causes, age-standardised death rates for schizophrenia declined, those for affective psychosis showed no change, and those for depression and dementia increased.
The decline in mortality rates for schizophrenia, and the increase for depression and dementia, may reflect real changes over time in disease prevalence at death, although other explanations are possible and are discussed.
精神疾病有时会在死亡证明上被认证，但很少被选为根本死因。大多数有认证精神病因的死亡通常会被排除在官方死亡率统计之外，官方死亡率统计通常仅基于根本死因。
报告死亡证明上认证的精神疾病死亡率，包括所有提及的病因以及根本死因。
分析数据库，该数据库包含1979 - 1999年所有认证的死因，按编码规则变化定义了三个时间段。
根本死因统计严重低估了认证的精神疾病。例如，在我们研究的第一个时间段，他们遗漏了88%以精神分裂症为认证病因的死亡、98%的情感性精神病死亡以及96%的抑郁症死亡。随着时间推移，考虑所有认证病因，精神分裂症的年龄标准化死亡率下降，情感性精神病的死亡率无变化，抑郁症和痴呆症的死亡率上升。
精神分裂症死亡率下降，抑郁症和痴呆症死亡率上升，可能反映了随着时间推移死亡时疾病患病率的实际变化，尽管也可能有其他解释并在文中进行了讨论。
