Psychotropic medication among children who experience parental death to cancer

Abstract

The psychological consequences of losing a parent to cancer are unclear. We investigated whether experiencing parental death to cancer before 18 years of age increases the risk of psychotropic medication. We used register data of all children born in Denmark between 1 January 1987 and 31 December 2016 (N = 1,488,846). We assessed rate ratios (RRs) with 95% confidence intervals (CIs) for first redeemed prescription of antidepressants, anxiolytics and hypnotics according to parental death status using Poisson multi-state models. We further examined whether the associations differed according to the gender of the deceased parent, child's age at the time of death or the parental length of illness. Cancer-bereaved children had a significantly increased risk of first prescription of psychotropic medication (rate ratio, RR 1.22, 95% confidence interval, CI 1.10-1.34 for males; RR 1.18, 95% CI 1.09-1.28 for females). Associations were strongest if the parent had the same sex as the child and if the parent died within one year of diagnosis. The risk was highest during the first six months after the loss (RR 2.35, 95% confidence interval, CI 1.48-3.73 for males; RR 1.81, 95% CI 1.17-2.80 for females). Children who lose a parent to cancer, particularly in cases when the disease progressed quickly, may need extra psychological support, especially during the first six months after the death.

Mixed‐methods evaluation of a face‐to‐face educational intervention for health and social care professionals to deliver family‐centred cancer supportive care when a parent with dependent children is at end of life

“…11,12,14 This places parents and children at risk of adverse psychosocial outcomes, to include an increased risk among children for psychotropic medication when not prepared for the death of a parent. 6,7 This lack of support from professionals is disconcerting, as it is well-established…”

Parental death and initiation of antidepressant treatment in surviving children and youth: a national register-based matched cohort study

“… 9 We also found that the pattern of the HR over time was similar after natural and unnatural parental death, which was not clear in previous studies limited to cancer or sudden parental death. 7 , 9 …”

“… 5 There have been a few population-based studies examining parentally bereaved children and youth's antidepressant use. 6 , 7 , 8 However, none of them provided comprehensive analysis on how the risk of antidepressant initiation changed over time following parental death, although such information could be valuable for offering timely support for the bereaved child, as highlighted by a study examining 216 bereaved children over seven years. 9 Furthermore, the negative impact of parental death may also exacerbate over long term, through accumulation of stressors subsequent to the death such as family socioeconomic difficulties and other changes in family life.…”

Kanser Hastaliği Olan Ebeveynleri̇n Çocuklari: Etki̇ler Ve Yaklaşimlar

“…Aynı zamanda ebeveyni kanser hastalığı nedeniyle ölen çocuklara psikotrop ilaç reçete etme riskinde önemli bir artış görülmektedir. Ebeveyn çocukla aynı cinsiyetteyse ve ebeveyn tanıdan sonraki bir yıl içinde öldüyse bu risk daha da artabilir (Hoeg et al, 2021). Anne ve babasını kanser hastalığından kaybeden çocuklar, özellikle hastalığın hızlı ilerlediği durumlarda ve ölümden sonraki ilk altı ayda ekstra psikolojik desteğe ihtiyaç duyabilirler.…”