1991-2022年德国自杀趋势,考虑到未确定的故意死亡的错误分类 - - 一个时间序列分析
Alexandra Clement1, Edgar Mesquita2, Kahar Abdulla3
1Queen's University, Kingston, Ontario, Canada.
Journal of affective disorders
|October 19, 2025
概括
自杀死亡率显著下降,但自杀和不确定的故意死亡的不同趋势表明潜在的"隐藏自杀". 分析揭示了登记数据中的关键断点,可能与编码变化和公众意识活动有关.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 死亡率统计 死亡率统计
背景情况:
- 对未确定的意图 (USDR) 和自杀 (SSDR) 的年龄标准化死亡率的调查趋势对于了解潜在的报告不足至关重要.
- 分析USDR与SSDR的比率及其随着时间的推移而发生的变化,可以揭示死亡登记程序中的差异,通常被称为"隐藏的自杀".
研究的目的:
- 分析1991年至2022年德国自杀 (SSDR) 和自杀加未确定率 (SUSDR) 的趋势和差异.
- 在同一时期,确定不确定的故意死亡与自杀死亡的比例 (USDR与SSDR比率) 的趋势和断点.
主要方法:
- 采用了1991-2022年个人的德国死亡登记数据.
- 雇员结合点回归分析用于计算和分析自杀和不确定死亡率 (SDR).
- 计算了利率比率 (USDR/SSDR) 并应用时间序列分析来检测USDR与SSDR比率的结构变化.
主要成果:
- 在32年中,自杀死亡率 (SSDR) 降低了41.01%,未确定的故意死亡率 (USDR) 降低了19.55%.
- 在SSDR和SUSDR的趋势之间观察到显著差异 (p < 0.001).
- 美元对SSDR的比率在0.11和0.37之间波动,在1997年,2010年,2016年和2005年 (男性) 确定了断点.
结论:
- 在SSDR和SUSDR的不同趋势表明隐藏自杀的可能性.
- 确定的断点可能与国际疾病分类 (ICD) 编码 (1997年) 的变化以及媒体报道 (2010) 后公众意识的提高有关.
- 后期分析排除了因果关系的确定,但强调了需要仔细解释死亡率数据的必要性.
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