Discrepancies in Death Certificates, Public Health Registries, and Judicial Determinations in Italy.

The death certificate is mandated by civil law and serves as a medical-scientific document useful for biostatistics and epidemiological research. For a variety of reasons, death certificates can be misclassified. We reviewed data from self-inflicted deaths collected over an 8-year period by the Forensic Institute of the University Sacro Cuore of Rome ( Italy). Four hundred and thirty-five of 2904 were classified as self-inflicted deaths (15%). The comparison with death certificates processed by the local public health authority ( ASL) and by the Italian National Census Bureau ( Istat) and with the judicial investigation results available in the Italian Penal Court archive shows some discrepancies. One-hundred and twenty-four of 435 deaths were not considered to be self-inflicted but due to a crime (29% overrecording suicide) with a higher reduction for women, suggesting that it is easier to confuse a murder for suicide in female cases. Any discrepancies between the mortality and crime data are discussed in details. [ABSTRACT FROM AUTHOR]