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June 1981

Increased Suicide Risk: Fact or Artifact?-Reply

Author Affiliations

Psychiatry Clinic Washington University School of Medicine 4940 Audubon Ave St Louis, MO 63110

Arch Gen Psychiatry. 1981;38(6):721. doi:10.1001/archpsyc.1981.01780310121017

Dr Solomon has ably and accurately dealt with the general question of official statistics raised by Dr Boyd. It remains for me to address the authorities Dr Boyd cited for disqualifying official statistics. How well has Dr Boyd understood what he has read?

The WHO study Dr Boyd cited1 was not undertaken for so naive a purpose as "to examine why the rates of suicide varied by a factor of ten from one country to another." Rather, it was proposed that "a careful study is required of national differences in methods of case-finding and recording as well as derivation of suicide rates."1(p11) Large differences in practices and procedures were identified from country to country, and "even in one center, different ways of arriving at a decision can exist."1(p42) Since different ways may lead to the same end, this is not the same as saying that "the variations

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