Hamann Johannes, Kaps Beatrix, Brieger Peter
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
Ehemals Bezirkskrankenhaus Kempten, Fachkrankenhaus für Psychiatrie, Psychotherapie und Psychosomatik, Kempten, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2019 Dec;62(12):1422-1426. doi: 10.1007/s00103-019-03039-0.
Death certificates are the basis for German mortality statistics, including suicide statistics.
To examine death certificates that are issued in the context of suicide with special focus on the quality of doctors' entries, especially indications of suicide and the stated association between underlying illness and cause of death.
Data from the Allgäu Suicide Study were used. Police records (N = 626) containing the results of suicide investigations as well as death certificates were analysed.
There is great heterogeneity as to how physicians issue death certificates in the context of suicide. Clear indications of suicide are often missing and underlying illnesses are seldom mentioned. Nevertheless, there are only minor differences between the number of suicides recorded by the police compared to official statistics.
To improve the quality of death certificates in the context of suicide, physicians should give clearer indications of suicide and put more focus on logically explaining the causes of death. The mortality of mental illnesses might be underestimated when mental illnesses are not regularly mentioned as a potential cause for suicide.
死亡证明是德国死亡率统计（包括自杀统计）的基础。
检查在自杀情况下开具的死亡证明，特别关注医生填写内容的质量，尤其是自杀迹象以及所陈述的潜在疾病与死因之间的关联。
使用了来自阿尔高自杀研究的数据。分析了包含自杀调查结果以及死亡证明的警方记录（N = 626）。
医生在自杀情况下开具死亡证明的方式存在很大差异。自杀的明确迹象常常缺失，潜在疾病很少被提及。然而，与官方统计相比，警方记录的自杀人数仅有细微差异。
为提高自杀情况下死亡证明的质量，医生应给出更明确的自杀迹象，并更注重从逻辑上解释死因。当精神疾病未被定期列为自杀的潜在原因时，精神疾病的死亡率可能被低估。
