Offspring death and subsequent psychiatric morbidity in bereaved parents: addressing mechanisms in a total population cohort

Ljung, Tryggve; Sandin, Sven; Långström, Niklas; Runeson, Bo; Lichtenstein, Paul; Larsson, Henrik

doi:10.1017/s0033291713002572

Cited by 10 publications

(14 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We have previously reported that as compared to a matched sample from the general population (not considered in the present investigation), our study population has very similar proportions reporting a history of psychological morbidity which debuted more than 10 years earlier (14% vs 14%) [ 3 ]. The higher risk of depression among parents with a history of suicide in other biological relatives, as well as among biological parents, on the other hand seem in line with previous reports of familial patterns in predisposition for psychological morbidity among families of suicide victims [ 2 , 4 , 20 ]. Neither finding is however inconsistent with there being a minority subgroup among suicide-victims with a predominantly familial component, since we have little information on the severity of the morbidity among the suicide-bereaved parents who report a history of psychological morbidity.…”

Section: Discussionsupporting

confidence: 87%

“…The loss of a child by suicide is a severe trauma that is associated with higher risks of long-term psychological morbidity as compared to parents from the general population [ 1 – 4 ], and parents bereaved from non-violent causes [ 1 , 4 – 7 ]. Suicide-bereaved parents have a higher suicide risk [ 8 ] and overall mortality [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…From register-based research and small sample questionnaire and interview studies on groups of bereaved who have lost a next-of-kin to suicide, a number of risk factors have been suggested for psychological morbidity and proxies such as psychiatric admission or subsequent death by suicide. These include general predictors of morbidity such as sex, age and socio-economics [ 7 , 17 , 18 ], history of psychological morbidity [ 8 , 17 ], suicide-specific predictors such as prior suicide attempts in the deceased and exposure to the dead body [ 19 ], and biological or social predisposition as indicated by familial patterns in psychological morbidity and suicide [ 4 , 8 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Depression among Parents Two to Six Years Following the Loss of a Child by Suicide: A Novel Prediction Model

et al. 2016

View full text Add to dashboard Cite

BackgroundParents who lose a child by suicide have elevated risks of depression. No clinical prediction tools exist to identify which suicide-bereaved parents will be particularly vulnerable; we aimed to create a prediction model for long-term depression for this purpose.MethodDuring 2009 and 2010 we collected data using a nationwide study-specific questionnaire among parents in Sweden who had lost a child aged 15-30 by suicide in years 2004-2007. Current depression was assessed with the Patient Health Questionnaire (PHQ-9) and a single question on antidepressant use. We considered 26 potential predictors assumed clinically assessable at the time of loss, including socio-economics, relationship status, history of psychological stress and morbidity, and suicide-related circumstances. We developed a novel prediction model using logistic regression with all subsets selection and stratified cross-validation. The model was assessed for classification performance and calibration, overall and stratified by time since loss.ResultsIn total 666/915 (73%) participated. The model showed acceptable classification performance (adjusted area under the curve [AUC] = 0.720, 95% confidence interval [CI] 0.673-0.766), but performed classification best for those at shortest time since loss. Agreement between model-predicted and observed risks was fair, but with a tendency for underestimation and overestimation for individuals with shortest and longest time since loss, respectively. The identified predictors include female sex (odds ratio [OR] = 1.84); sick-leave (OR = 2.81) or unemployment (OR = 1.64); psychological premorbidity debuting during the last 10 years, before loss (OR = 3.64), or more than 10 years ago (OR = 4.96); suicide in biological relatives (OR = 1.54); with non-legal guardianship during the child’s upbringing (OR = 0.48); and non-biological parenthood (OR = 0.22) found as protective.ConclusionsOur prediction model shows promising internal validity, but should be externally validated before application. Psychological premorbidity seems to be a prominent predictor of long-term depression among suicide-bereaved parents, and thus important for healthcare providers to assess.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Depression among Parents Two to Six Years Following the Loss of a Child by Suicide: A Novel Prediction Model

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Death of an infant or child has been described as the most stressful of all life events. 1 Parents' grief, depression, posttraumatic stress disorder (PTSD), and psychiatric hospitalization [2][3][4][5][6] are well documented, whereas effects on physical health are not. 7 Bereavement research has found immune imbalance, cortisol response, altered sleep, inflammatory cell mobilization, and hemodynamic changes in heart rate and blood pressure following loss of a loved one.…”

Section: Introductionmentioning

confidence: 99%

“…Parent morbidity after child death has been studied in large national Scandinavian data sets years after the child’s death 4,5,9 and recently in 1 longitudinal US study. 10 Results show increased cancers, 11 diabetes, 12 myocardial infarctions, 13 newly diagnosed chronic conditions, hospitalizations, and many needed changes in medications.…”

Section: Introductionmentioning

confidence: 99%

Parents’ Acute Illnesses, Hospitalizations, and Medication Changes During the Difficult First Year After Infant or Child NICU/PICU Death

Brooten

Youngblut

Caicedo

et al. 2016

Am J Hosp Palliat Care

View full text Add to dashboard Cite

Background and Objectives Infant/child death is described as a most stressful life event; however, there are few reports of effects on parent physical health during the first year after the death. The study’s purpose is to examine the patterns of parent acute illnesses, hospitalizations, and medication changes over 1 to 13 months after neonatal intensive care unit (NICU) or pediatric intensive care unit (PICU) infant/child death in 3 racial/ethnic groups. Methods Secondary analyses were conducted with longitudinal data on parent health and functioning 1 to 13 months after infant/child NICU/PICU death. Parents (176 mothers, 73 fathers; 44% Hispanic, 35% black non-Hispanic, and 21% white non-Hispanic) of deceased infants/children were recruited from 4 children’s hospitals and state death records. Inclusion criteria—parents understood English or Spanish and had a deceased neonate/child ≤ 18. Exclusion criteria—deceased newborn from multiple gestation pregnancy, child in foster care, child’s injury due to suspected abuse, or parent death in illness/injury event. Parents reported numbers and types of acute illnesses, hospitalizations, and medication changes 1 to 13 months postdeath. Results Parents’ acute illnesses, hospitalizations, and medication changes were greatest between months 1 and 6, with relative quiescence in months 7 to 10, and an increase in months 11 to 13. Mothers (aged 32 ± 7.8 years) reported 300 acute illnesses (primarily colds/flu, headaches, anxiety/depression, and infections) and 89 hospitalizations (primarily infections, chest pain, and gastrointestinal problems). Fathers (aged 37 ±8.8 years) reported 104 acute illnesses (colds/flu and headaches) and 9 hospitalizations. Conclusion After infant/child NICU/PICU death, mothers had greater morbidity than fathers, with no significant differences by race/ethnicity. Parents’ health needs to be monitored in months 1 to 6 and months 11 to 13, and interventions targeted to parents in these months.

show abstract

Work‐related consequences of losing a child with cancer: A nationwide population‐based cohort study

Hammer,

Olsen,

Larsen

et al. 2023

Pediatric Blood & Cancer

View full text Add to dashboard Cite

BackgroundParents who lose a child are at increased risk of impaired mental health, which may negatively affect their work ability. The aims of this study were to examine the risk for reduced labor market affiliation in parents who lost a child with cancer compared to a matched parent cohort, and factors associated with the bereaved parents’ labor market affiliation.MethodsWe conducted a nationwide population‐based cohort study using Danish registry data. We followed bereaved parents (n = 1609) whose child died with cancer at age less than 30 during 1992–2020, and a matched, population‐based sample of parents (n = 15,188) of children with no history of childhood cancer. Cox proportional hazard models and fractional logit models were performed separately for mothers and fathers.ResultsCancer‐bereaved mothers had an overall increased risk of long‐term sick leave (hazard ratio [HR] = 1.62; 95% confidence interval [CI]: 1.48–1.77), unemployment (HR = 1.53; CI: 1.37–1.70), and lower odds of working in the first 2 years following the loss (odds ratio [OR] = 0.44; CI: 0.39–0.49), while bereaved fathers had lower odds of working (OR = 0.65; CI: 0.53–0.79), and increased risk of permanently reduced work ability (HR = 1.29; 95% CI: 1.01–1.66), compared to the matched cohort of parents of cancer‐free children. Younger parental age, lower education, and being a single parent were identified as the main determinants of the bereaved parents’ reduced labor market affiliation.ConclusionsCancer‐bereaved parents are at increased risk of reduced labor market affiliation, compared with a matched, population‐based sample of parents. Certain groups of bereaved parents may be at particularly high risk, and targeted bereavement interventions are warranted.

show abstract

Offspring death and subsequent psychiatric morbidity in bereaved parents: addressing mechanisms in a total population cohort

Cited by 10 publications

References 32 publications

Depression among Parents Two to Six Years Following the Loss of a Child by Suicide: A Novel Prediction Model

Depression among Parents Two to Six Years Following the Loss of a Child by Suicide: A Novel Prediction Model

Parents’ Acute Illnesses, Hospitalizations, and Medication Changes During the Difficult First Year After Infant or Child NICU/PICU Death

Work‐related consequences of losing a child with cancer: A nationwide population‐based cohort study

Contact Info

Product

Resources

About