Exposure to trauma in childhood or adolescence has been shown to be associated with a variety of deleterious mental health outcomes including, psychotic experiences, 1,2 depression, 3 bipolar disorder 4 and psychosis. 5 Specifically, metaanalyses have shown that those exposed to any form of childhood maltreatment are much more likely to report
Objective
To systematically review evidence for an association between parental death in childhood, and the subsequent development of an anxiety, affective or psychotic disorder.
Methods
Electronic databases (Scopus, Medline (for Ovid), EMBASE and PsychINFO) were searched for peer‐reviewed, cohort studies in the English language. Meta‐analyses were performed for studies reporting hazard ratios, incidence rate ratios and odds ratios. Two studies reported risk ratios, and these were included in an overall pool of odds, risk and incidence rate ratios. Sensitivity analyses were performed (removal of one study at a time) for all meta‐analyses, and study quality assessed using the Newcastle‐Ottawa Scale.
Results
Fifteen studies were retained, and where required, data were averaged in advance of pooling. Significant results were observed in studies reporting hazard ratios (k = 4, 1.48 [95% CI = 1.32–1.66]), incidence rate ratios (k = 3, 1.37 [95% CI = 1.01–1.85]), but not odds ratios (k = 4, 0.87 [95% CI = 0.72, 1.05]). However, the overall pooled effect (using odds, incidence rate and risk ratios) was statistically significant (k = 9, 1.22 [95% CI = 1.03–1.44]).
Conclusion
Overall, the evidence suggests that there is a positive association between the death of a parent before age 18, and the subsequent development of an anxiety, affective or psychotic disorder. The lack of a significant pooled effect in studies reporting results as odds ratios is likely an artefact of study design.
Limitations
Data were clustered in four countries making generalizability uncertain. Studies adjusted for a variety of possible confounders, and follow‐up after death varied considerably.
Conditions to store toll-like receptor2/6 sensors and use them to detect bacterial analytes, including pathogen-associated molecular patterns and bacterial cultures.
Summary
A 35 year old man was treated for stage IIA Hodgkin's disease by radiation to the upper thorax, axillae and neck. Three years later he presented with intractable and ultimately fatal congestive heart failure.
Autopsy revealed massive biventricular hypertrophy with widespread subendocardial fibrosis and myocardial infarction, but with little coronary artery disease. Such a complex of features has not previously been described after radiation therapy and cannot be adequately explained by other known causes of heart muscle disease. Ventricular hypertrophy with extensive subendocardial fibrosis may be part of the spectrum of radiation heart disease.
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