title: Improving suicide mortality statistics in Tarragona (Catalonia, Spain) between 2004-2012.
abstract: BACKGROUND
  Monitoring and preventing suicidal behaviour requires, among other data, knowing suicide deaths precisely. They often appear under-reported or misclassified in the official mortality statistics. The aim of this study is to analyse the under-reporting found in the suicide mortality statistics of Tarragona (a province of Catalonia, Spain).
  
  
  METHODS
  The analysis takes into account all suicide deaths that occurred in the Tarragona Area of the Catalan Institute of Legal Medicine and Forensic Sciences (TA-CILMFS) between 2004 and 2012. The sources of information were the death data files of the Catalan Mortality Register, as well as the Autopsies Files of the TA-CILMFS. Suicide rates and socio-demographic profiles were statistically compared between the suicide initially reported and the final one.
  
  
  RESULTS
  The mean percentage of non-reported cases in the period was 16.2%, with a minimum percentage of 2.2% in 2005 and a maximum of 26.8% in 2009. The crude mortality rate by suicide rose from 6.6 to 7.9 per 100,000 inhabitants once forensic data were incorporated. Small differences were detected between the socio-demographic profile of the suicide initially reported and the final one. Supplementary information was obtained on the suicide method, which revealed a significant increase in poisoning and suicides involving trains.
  
  
  CONCLUSIONS
  An exhaustive review of suicide deaths data from forensic sources has led to an improvement in the under-reported statistical information. It also improves the knowledge of the method of suicide and personal characteristics.
authors.affiliation: Institut de Medicina Legal de Catalunya i Ciències Forenses, Departament de Justícia, Tarragona, España; Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, España. Electronic address: eneko.barberia@xij.gencat.cat.
authors.forename: Eneko
authors.initials: E
authors.lastname: Barbería
authors.affiliation: Registre de Mortalitat, Servei d'Informació i Estudis, Departament de Salut, Barcelona, España.
authors.forename: Rosa
authors.initials: R
authors.lastname: Gispert
authors.affiliation: Institut de Medicina Legal de Catalunya i Ciències Forenses, Departament de Justícia, Tarragona, España; Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, España.
authors.forename: Belén
authors.initials: B
authors.lastname: Gallo
authors.affiliation: Registre de Mortalitat, Servei d'Informació i Estudis, Departament de Salut, Barcelona, España.
authors.forename: Gloria
authors.initials: G
authors.lastname: Ribas
authors.affiliation: Registre de Mortalitat, Servei d'Informació i Estudis, Departament de Salut, Barcelona, España.
authors.forename: Anna
authors.initials: A
authors.lastname: Puigdefàbregas
authors.affiliation: Registre de Mortalitat, Servei d'Informació i Estudis, Departament de Salut, Barcelona, España.
authors.forename: Adriana
authors.initials: A
authors.lastname: Freitas
authors.affiliation: Institut de Medicina Legal de Catalunya i Ciències Forenses, Departament de Justícia, Tarragona, España.
authors.forename: Elena
authors.initials: E
authors.lastname: Segú
authors.affiliation: Institut de Medicina Legal de Catalunya i Ciències Forenses, Departament de Justícia, Tarragona, España.
authors.forename: Pilar
authors.initials: P
authors.lastname: Torralba
authors.affiliation: Institut de Medicina Legal de Catalunya i Ciències Forenses, Departament de Justícia, Tarragona, España; Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, España.
authors.forename: Francisco
authors.initials: F
authors.lastname: García-Sayago
authors.affiliation: Institut de Medicina Legal de Catalunya i Ciències Forenses, Departament de Justícia, Tarragona, España.
authors.forename: Aina
authors.initials: A
authors.lastname: Estarellas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D002423:Cause of Death; D000068598:Data Accuracy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058996:Quality Improvement; D012042:Registries; D013030:Spain / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data*; D000092864:Suicide Prevention
keywords: Estadísticas vitales; Forensic Medicine; Medicina Forense; Mortalidad; Mortality; Public Health; Salud Pública; Suicide; Suicidio; Vital Statistics