Estonian-Swedish Mental Health and Suicidology Institute, Estonian Centre of Behavioural and Health Sciences, Tallinn, Estonia.
Scand J Public Health. 2010 Jun;38(4):395-403. doi: 10.1177/1403494809354360. Epub 2009 Nov 18.
Observed changes in subcategories of injury death were used to test the hypothesis that a sizeable proportion of ''injury deaths of undetermined intent'' (Y10-Y34 in ICD 10) in the Baltic and Slavic countries after the USSR dissolved in 1991 were hidden suicides.
Using male age-adjusted suicide rates for two distinctly different periods, 1981-90 and 1992-2005, changes, ratios and correlations were calculated. The data were compared with the EU average.
After the USSR broke up, the obligation to make a definitive diagnosis became less strict. A massive increase in ''injury deaths of undetermined intent'' resulted. The mean rate for the second period reached 52.8 per 100,000 males in Russia (the highest rate) and 12.9 in Lithuania (the lowest), against 3.2 in EU-15. The rise from the first to the second period was highest in Belarus (56%) and Russia (44%). The number of injury deaths of undetermined intent was almost equal to that of suicides in Russia in 2005 (ratio 1.0) and Ukraine in 2002 (1.1). In all the countries, especially the Slavic ones, prevalence trends of injury-death subcategories were uniform, i.e. strongly correlated over time. No direct substitution of one diagnosis for another was evident.
There is no evidence that the category of ''injury deaths of undetermined intent'' in the Baltic and Slavic countries hides suicides alone. Aggregate level analysis indicates that accidents and homicides could sometimes be diagnosed as undetermined.
利用伤害死亡亚类的变化来检验下述假设，即在 1991 年苏联解体后，波罗的海和斯拉夫国家中相当一部分“原因不明的伤害死亡”（ICD-10 中的 Y10-Y34）实际上是隐藏的自杀。
利用两个截然不同时期的男性年龄调整自杀率，即 1981-1990 年和 1992-2005 年，计算变化、比率和相关性。将数据与欧盟平均水平进行比较。
苏联解体后，明确诊断的义务变得不那么严格。“原因不明的伤害死亡”数量大量增加。第二期的平均比率在俄罗斯达到 52.8/10 万男性（最高），立陶宛 12.9/10 万男性（最低），而欧盟 15 国为 3.2/10 万男性。白俄罗斯（56%）和俄罗斯（44%）从第一期到第二期的上升幅度最大。2005 年，俄罗斯（比率 1.0）和 2002 年乌克兰（比率 1.1）的“原因不明的伤害死亡”数量几乎与自杀人数相等。在所有国家，特别是斯拉夫国家，伤害死亡亚类的流行趋势是一致的，即随时间推移具有很强的相关性。没有明显的一种诊断取代另一种诊断的情况。
没有证据表明波罗的海和斯拉夫国家的“原因不明的伤害死亡”类别仅隐藏自杀。总体水平分析表明，事故和凶杀有时可能被诊断为原因不明。
