Wasserman D, Värnik A
Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
Acta Psychiatr Scand Suppl. 1998;394:34-41. doi: 10.1111/j.1600-0447.1998.tb10763.x.
The stability of the relationship between trends of violent deaths as a whole, suicides and death from undetermined causes was assessed by quantitative methods for the whole former USSR in the years 1970-1990 and for each of the 15 republics in the former USSR for the years 1984-1990. Semi-structured interviews during 1989-1996 were performed with 12 professionals involved in the diagnosis and coding of causes of death in the Baltic states and Russia. The quantitative analyses showed that mortality data were reliable for the Slavic (Russia, the Ukraine and Belarus) and Baltic (Estonia, Latvia and Lithuania) republics, and also for Kazakhstan, Kirgizia and Moldova. The Central Asian and Caucasian republics showed greater variation in trends and ratios, indicating a need for further investigations of the reliability of suicide statistics in these regions. It emerged from the interviews that no instructions to falsify data were given. The only instructions given were to treat the data on suicide and murder as 'top secret'. None the less, certain classification errors might arise in the statistics. The diagnosis 'undetermined cause of death' was permissible only as a preliminary diagnosis for 14 days, and there was a risk of criticism for poor-quality work if too many deaths were classified as being due to undetermined causes. Misclassifications could also occur in cases where there was a wish to conceal murder. Negative attitudes towards suicide, especially in Muslim regions, where suicide is taboo, might also have contributed to under-reporting of suicide.
采用定量方法评估了1970年至1990年整个前苏联以及1984年至1990年苏联15个加盟共和国中暴力死亡总数、自杀和死因不明死亡之间关系的稳定性。1989年至1996年期间，对波罗的海国家和俄罗斯12名参与死因诊断和编码的专业人员进行了半结构化访谈。定量分析表明，斯拉夫（俄罗斯、乌克兰和白俄罗斯）和波罗的海（爱沙尼亚、拉脱维亚和立陶宛）加盟共和国以及哈萨克斯坦、吉尔吉斯斯坦和摩尔多瓦的死亡率数据可靠。中亚和高加索加盟共和国的趋势和比率变化较大，表明需要进一步调查这些地区自杀统计数据的可靠性。访谈结果显示，没有给出伪造数据的指示。给出的唯一指示是将自杀和谋杀数据视为“绝密”。尽管如此，统计数据中仍可能出现某些分类错误。“死因不明”的诊断仅在14天内作为初步诊断是允许的，如果将过多死亡归类为死因不明，可能会因工作质量差而受到批评。在希望隐瞒谋杀的情况下也可能发生错误分类。对自杀的负面态度，特别是在自杀被视为禁忌的穆斯林地区，也可能导致自杀报告不足。
