Time to Hospitalization for Suicide Attempt by the Timing of Parental Suicide During Offspring Early Development

Kuramoto, S. Janet; Runeson, Bo; Stuart, Elizabeth A.; Lichtenstein, Paul; Wilcox, Holly C.

doi:10.1001/jamapsychiatry.2013.274

Cited by 44 publications

(50 citation statements)

References 36 publications

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“…For children bereaved by parental suicide at an early age, however, the risk of suicidal behavior does not commence to increase until some years after the loss of the parent and then increases for decades. 31 If a similar pattern would be assumed to follow bereavement by IPF or IPF-suicide, the limited follow-up time of the current study might have failed to capture late suicides. In line with our findings, the risk of being convicted for a violent crime is also elevated for offspring bereaved of a parent by any cause and regardless of age at loss.…”

Section: Offspring Consequencesmentioning

confidence: 93%

Killing the Mother of One’s Child

Lysell

Dahlin²,

Långström³

et al. 2016

J. Clin. Psychiatry

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Objective: To study possible psychiatric and criminological risk factors of intimate partner femicide (IPF) as well as the bereaved offspring's psychiatric morbidity and premature death. Method: We conducted a nested case-control study, based on Swedish national registries, including all perpetrators of IPF. We computed risk estimates relative to matched population controls, which were compared to those of non-IPF homicide offenders. Exposed children were matched to population controls and followed longitudinally up to 37 years. Offspring outcomes were psychiatric and substance use disorders (according to ICD) self-harm; violent crime; suicide; and premature, all-cause death. Results: We identified 261 male IPF perpetrators and 494 bereaved children from 1973 through 2009. Multivariable logistic regression suggested that major mental disorder (adjusted odds ratio [OR] = 5.9; 95% CI, 3.3-10.6) and violent crime convictions (adjusted OR = 4.4; 95% CI, 2.7-7.2) were independent risk factors of IPF, but substance use disorders were not (aOR = 0.4; 95% CI, 0.2-1.0). Children exposed to IPF before age 18 years had elevated risks of major mental disorder (adjusted hazard ratio [HR] = 5.7; 95% Cl, 3.0-10.6), substance use disorders (adjusted HR = 5.8; 95% CI, 2.8-11.9) and self-harm (adjusted HR = 5.7; 95% CI, 3.0-11.1). Offspring 18 years or older at the IPF had an increased risk of completed suicide (adjusted HR = 4.3; 95% CI, 1.3-14.5). Conclusions: Previous major mental disorder and violent behavior were strong independent risk factors for IPF. Bereavement caused by IPF had significant associations with the offspring's future life, especially for those below 18 years of age at exposure. Our findings demonstrate the need of direct support to the exposed offspring by health care providers and social services.

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Section: Offspring Consequencesmentioning

confidence: 93%

Killing the Mother of One’s Child

Lysell

Dahlin²,

Långström³

et al. 2016

J. Clin. Psychiatry

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“…Naturally, the children of the deceased are highly impacted by this loss given the broken attachment to a primary care giver [3] and the direct effect of loss on daily life [4]. The sudden death of a parent is consequently associated with an increased risk of longterm psychosocial sequela [5][6][7], and several Scandinavian population-based register studies have reported an increased risk of hospital treatment for deliberate self-harm (DSH) in bereaved offspring [5,[8][9][10][11][12][13][14][15][16][17]. When directly comparing offspring bereaved by suicide and accidents, researchers have reported an earlier onset of DSH hospitalization in offspring following parental suicide compared to those parentally bereaved by accidental death [9].…”

Section: Introductionmentioning

confidence: 99%

Parental death by external causes and risk of hospital-treated deliberate self-harm in bereaved offspring

Burrell

Mehlum

Qin

2020

Eur Child Adolesc Psychiatry

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Previous studies have reported an increased risk of hospital-treated deliberate self-harm (DSH) in offspring who have lost a parent, but inconclusive findings regarding differences between loss from suicide and accidents. The present study aimed to investigate the association between parental death by external causes before age 18 and hospital-treated DSH, and potential differences between different accidents and suicide. This nested-case-control study was based on data from longitudinal Norwegian registers. Subjects comprised 12,526 people born between 1970 and 2003 who received acute somatic treatment because of DSH at hospitals and associated services between 2008 and 2013 (cases), and 222,362 controls matched for gender and date of birth with no recorded DSH treatment. Information concerning deceased parent's death and offspring's DSH treatment and socioeconomic data was merged. Data were analysed with conditional logistic regression. Results indicated that offspring who had lost a parent to suicide (OR 2.32, 95% CI 1.92-2.80) and death by accidents such as falls, poisoning, and drowning (OR 1.79, 95% CI 1.38-2.33) had a significantly increased risk of hospital-treated DSH compared to offspring who had not experienced such loss. Parental bereavement from transport accidents and other external causes were not associated with significantly increased risks. No differences were evident for different genders of deceased, ages at bereavement, or genders of bereaved. The improved identification of bereaved offspring at particular risk of hospitaltreated DSH should be utilized to implement effective prevention and treatment programs in specialist healthcare aimed at the individuals at highest risk.

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“…5,6 These bereaved children have been shown to have an increased longterm risk of developing mental health problems and committing suicide, [6][7][8][9][10] but little is known about the long-term risk of suicide among children who had a parent who died from other causes. 1,8,9,11,12 Few studies have had sufficient size and follow-up time to investigate the long-term risk of suicide among children with additional vulnerabilities, yet studies point to the following factors impacting suicide risk: low socioeconomic status, family history of psychiatric illness, 9,[12][13][14][15] young age at the time of parental death, 9,10,16,17 and maternal suicide. 10,18,19 We hypothesized that accidental and suicidal parental death and shared genes increase the suicide risk among the offspring.…”

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confidence: 99%

Incidence of Suicide Among Persons Who Had a Parent Who Died During Their Childhood

et al. 2015

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IMPORTANCE Parental death from suicide is associated with increased risk of suicide in the bereaved child, but little is known about the long-term risks of suicide after parental death from other causes. A better understanding of this association may improve suicide prevention efforts. OBJECTIVE To examine the long-term risks of suicide after parental death and how the risk trajectories differed by cause of parental death while accounting for major potential confounding variables. DESIGN, SETTING, AND PARTICIPANTS A population-based matched cohort study was performed using information from nationwide registers (data from 1968 to 2008) in 3 Scandinavian countries (for a total of 7 302 033 persons). We identified 189 094 children (2.6%) who had a parent who died before the child reached 18 years of age (ie, the bereaved cohort). Each bereaved child was matched by sex and age to 10 children who did not have a parent who died before they reached 18 years of age (for a total of 1 890 940 children) (ie, the reference cohort). Both cohorts were followed for up to 40 years. Poisson regression was used to calculate the incidence rate ratio (IRR), while accounting for age at parental death, sex, time since bereavement, maternal/paternal death, birth order, family history of psychiatric illness, and socioeconomic status. Data analyses were finalized June 24, 2015. EXPOSURE The main exposure was death of a parent within the first 18 years of life. MAIN OUTCOMES AND MEASURES Incidence of suicide among persons who had a parent who died during their childhood. RESULTS During follow-up, 265 bereaved persons (0.14%) and 1342 nonbereaved persons (0.07%) died of suicide (IRR = 2.02 [95% CI, 1.75-2.34]); IRR = 3.44 (95% CI, 2.61-4.52) for children who had a parent who died of suicide, and IRR = 1.76 (95% CI, 1.49-2.09) for children who had a parent who died of other causes. The IRR tended to be higher for children who had a parent who died before they reached 6 years of age, and the IRR remained high for at least 25 years. During 25 years of follow-up, the absolute risk of suicide was 4 in 1000 persons for boys who experienced parental death and 2 in 1000 persons for girls who experienced parental death. CONCLUSIONS AND RELEVANCE Parental death in childhood is, irrespective of cause, associated with an increased long-term risk of suicide. The consequences of parental death in childhood are far-reaching, and suicide risk trajectories may be influenced by early-life conditions. Future public health efforts should consider helping highly distressed children to cope with bereavement.

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Time to Hospitalization for Suicide Attempt by the Timing of Parental Suicide During Offspring Early Development

Cited by 44 publications

References 36 publications

Killing the Mother of One’s Child

Killing the Mother of One’s Child

Parental death by external causes and risk of hospital-treated deliberate self-harm in bereaved offspring

Incidence of Suicide Among Persons Who Had a Parent Who Died During Their Childhood

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