Selvmord fra en rettsmedisinsk innfallsvinkel

Abstract

Abstract Background: An autopsy is still the most accurate method to determine the cause of death. Because of this, the reliability of suicide statistics in a country is highly dependent on its autopsy rates. Among several reasons, including low autopsy rates, the under-reporting of suicide in Norway has previously been estimated to be around 25% or more. In this review the reliability of Norwegian suicide statistics and Norwegian autopsy rates were assessed by a systematic search in different databases. Methods: In January 2014, the databases PubMed and SveMed+ were screened for articles containing studies regarding the reliability of suicide statistics in Norway and/or Norwegian autopsy rates. The search strategy of choice in PubMed was made in free text with the following terms: (suicide OR forensic autopsy OR medicolegal autopsy) AND Norway. In SveMed+ the search strategy included the terms: «selvmord», «obduksjon» and «Norge». The search results were screened by reading the title, and if regarded necessary also the abstract and full text. The Norwegian medicolegal autopsy rates were determined from annual reports from The Norwegian Board of Forensic Medicine and The Central Bureau of Statistics in Norway (SSB). Results: The searches generated a total of 850 hits. Of these, only 18 articles published between 1985 and 2012 met the inclusion criteria. Five annual reports from The Norwegian Board of Forensic Medicine and from SSB were included; these provided the autopsy rates in suicide fatalities in the period 2007-2011. The few studies included estimate that Norway has reliable suicide statistics with an under-reporting of suicide by 10% or less. The autopsy rates in suicide in the period 2007-2011 are estimated to be around 60%, which is considered to be low. Conclusions: There is little knowledge regarding the reliability of Norwegian suicide statistics. However, according to the few included studies in this review, the under-reporting of suicide in Norway is of 10% or less, which is low. Having said this, there is need for more research to verify these numbers. The autopsy rates in Norway vary tremendously depending on variables such as region, age, sex, cause of death and manner of death.