Trends in adolescent suicide: misclassification bias?
OBJECTIVE
This study investigated the effect of misclassification of accidental deaths and undetermined deaths on age-, sex-, and race/ethnicity-specific adolescent suicide rates from 1979 through 1994.


METHODS
Official mortality data were used to present suicide mortality trends. Two estimates of misclassified suicides in other death categories were applied to calculate "corrected" trends of adolescent suicide.


RESULTS
The corrected trends showed a downward adjustment for Black adolescent males and young adolescents. This result does not, however, substantially alter the trend toward a recent increase in suicide in these groups.


CONCLUSIONS
Despite misclassification, the true direction of trends in adolescent suicide is reflected in recent official data. However, suicide rates should continuously be tested for misclassification, mainly in populations with proportionately high accidental and undetermined death rates.
Mohler
B
B
Department of Maternal and Child Health, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA. bmohler@hsph.harvard.edu
Earls
F
F
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D015982:Bias; D002423:Cause of Death; D002648:Child; D003644:Death Certificates; D005260:Female; D006801:Humans; D008297:Male; D017678:Sex Distribution; D013405:Suicide / Q000208:ethnology / Q000639:trends*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data