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PAPERS: Nestor D. Kapusta, Elmar Etzersdorfer, Christoph Krall, and Gernot Sonneck Firearm legislation reform in the European Union: impact on firearm availability, firearm suicide and homicide rates in Austria The British Journal of Psychiatry 2007; 191: 253-257 [Abstract] [Full text] [PDF]

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Authors Reply to the comment "Australian Firearms Data Requires a Cautious Approach"

Nestor D. Kapusta, Elmar Etzersdorfer, Gernot Sonneck   (25 September 2007)

Authors Reply to the comment "Australian Firearms Data Requires a Cautious Approach" 25 September 2007
Nestor D. Kapusta, Psychiartist Department of Psychoanalysis and Psychotherapy, Elmar Etzersdorfer, Gernot Sonneck Send letter to journal: Re: Authors Reply to the comment "Australian Firearms Data Requires a Cautious Approach" nestor.kapusta{at}meduniwien.ac.at Nestor D. Kapusta, et al.	McPhedran and Baker point out an unsolved problem of Australian suicide research. There are concerns about the quality of mortality data sources and statistics based upon them. Therefore, they urge researchers to approach Australian firearms data with caution. The authors cite a letter to the editor of the Medical Journal of Australia written by Diego De Leo (2007). Professor De Leo highlighted inconsistencies of Australian mortality data since the year 2001 and called for homogenized certification procedures of deaths according to ICD-10 and for other improvements of death registries. However, in Austria autopsies are performed when there is any uncertainty regarding the cause of death. The autopsy rate is high in international comparison and was in average 29% in 1991-2000 (Waldhoer et al, 2003). If the cause of death is not clear, an additional investigation by Statistics Austria takes place. Statistics Austria registers deaths as suicide if that is the most probable cause of death. The International Classification of Diseases (ICD-8, -9, -10) has been applied for many years and there are no signs of a decrease of the data quality of Statistics Austria. The work of Kapusta et al. (2007) is based on these data. Furthermore, De Leo (2007) realistically states that some under- reporting is ubiquitous and has to be tolerated in suicide statistics. On the other hand, under-reporting of firearm-deaths seems less probable than under-reporting of e.g. deaths due to poisonings (longer survival periods) which tend to be classified as disease-related deaths. We agree with McPhedran and Baker, that Australian firearm laws should be re-evaluated on the basis of more reliable data. But as long as sufficient evidence is not available, theoretical assumptions that Australian firearm laws had no life-saving effects remain speculative - from a scientific point of view. This applies also to Europe, where independent scientific firearm law evaluations are still rare. Declaration of interest: None De Leo, D. (2007). Suicide mortality data needs revision. Medical Journal of Australia, 186, 157. Kapusta, N.D., Etzerdorfer, E., Krall, C., & Sonneck, G. (2007). Firearm legislation reform in the European Union: impact on firearm availability, firearm suicide and homicide rates in Austria. British Journal of Psychiatry, 191, 253-257. Waldhoer, T., Berzlanovich, A., Vutuc, C., & Haidinger, G. (2003). Rates of postmortem examination in Austria: the effect of distance between location of death and site of examination. Journal of Clinical Epidemiology, 56(9), 891-5. ----------- Nestor D. KAPUSTA, M.D. Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Austria, nestor.kapusta@meduniwien.ac.at Elmar ETZERSDORFER, Prof. M.D. Furtbach Hospital for Psychiatry and Psychotherapy, Stuttgart,Germany Gernot SONNECK, Prof. M.D. Institute for Medical Psychology, Medical University of Vienna, Austria