Physical and psychosomatic health outcomes in people bereaved by suicide compared to people bereaved by other modes of death: a systematic review

Abstract

BackgroundLittle research has been conducted into the physical health implications of suicide bereavement compared to other causes of death. There is some evidence that suicide bereaved parents have higher morbidity, particularly in terms of chronic illness. This systematic review aims to examine the physical and psychosomatic morbidities of people bereaved by a family member’s suicide and compare them with family members bereaved by other modes of death.MethodsMEDLINE, EMBASE, CINAHL, and PsycINFO were searched from 1985 to February 2016. The search was re-run in March 2017. Peer-reviewed English language articles comparing suicide-bereaved family members to non-suicide bereaved family members on measures of physical or psychosomatic health were eligible for inclusion. Cohort, cross-sectional, case-control and cohort-based register studies were eligible for inclusion. A modified version of the Newcastle Ottawa Scale was used for quality assessment. Results were synthesised using narrative synthesis.ResultsThe literature search located 24 studies which met the inclusion criteria. Seven studies found statistically significant associations between physical health and suicide bereavement. Five of the studies found that suicide-bereaved family members were more likely to experience pain, more physical illnesses and poorer general health. They were also at increased risk of cardiovascular disease, hypertension, diabetes and chronic obstructive pulmonary disease. In contrast, another study in Denmark found that those bereaved by suicide had a lower risk of a number of physical health disorders, including cancers, diabetes, cardiovascular and chronic lower respiratory tract disorders compared to those bereaved by other causes of death. Additionally, a further study conducted in the United States found that suicide-bereaved children visited a GP less frequently than non-suicide bereaved children.ConclusionsReview findings are relevant for clinicians working with people bereaved by suicide as they highlight that such clients are at increased risk of several adverse physical health outcomes. Future research should examine health risk behaviours of suicide-bereaved and non-suicide bereaved family members as they may confound the association between exposure and outcome.Trial RegistrationsThe review protocol has been registered on PROSPERO, registration number CRD42016030007.Electronic supplementary materialThe online version of this article (10.1186/s12889-017-4930-3) contains supplementary material, which is available to authorized users.

How suicide-bereaved family members experience the inquest process: a qualitative study using thematic analysis

“…This is a qualitative study, which utilised semi-structured interviews with 18 people bereaved by a family member's suicide. These data for this study were collected during interviews for a previously published mixed methods study (Spillane et al, 2017(Spillane et al, , 2018. The aim of the previous mixed methods study was to examine the physical and psychological health effects of suicide bereavement on family members in Ireland.…”

“…Meaning-making following loss is crucial, but can be especially complex for suicide-bereaved family members, (Currier, Holland, & Neimeyer, 2006;Pritchard & Buckle, 2017) as they struggle with mental, physical and psychosomatic problems, including depression, nausea, vomiting, diabetes and hypertension (Bolton et al, 2013;Spillane et al, 2017;Spillane, Matvienko-Sikar, Larkin, Corcoran, & Arensman, 2018). Family members bereaved by suicide are at an increased risk of mood disorders, substance use disorders, complicated grief and post-traumatic stress disorder (de Groot, de Keijser, & Neeleman, 2006;Erlangsen et al, 2017).…”

Experiences of support from primary care and perceived needs of parents bereaved by suicide: a qualitative study

“…11,12 Outcomes are further complicated by relatives and friends of people who have died by suicide having higher levels of perceived stigma, shame, responsibility, and guilt than those bereaved by other causes of death. 11,13 Feelings such as shame and stigma will likely influence help-seeking behaviour among this group, 11,14 and their potential awareness of avenues of support. This may in turn negatively impact on health outcomes.…”

Being Pro-Active in Meeting the Needs of Suicide-Bereaved Survivors: results from an audit in Montreal

“…Dealing with a loved one's suicide can be extremely challenging for suicide-bereaved survivors (SBS), so much so that they may become more vulnerable to an array of problems (5). The situation can have an impact on the bereavement process, the development of somatic or mental health disorders and, ultimately, suicide risk (6)(7)(8)(9)(10)(11). SBS often have di culty seeking help because they may have lost con dence in the health and social services systems that failed their loved one, do not dare to consult, are isolated, or feel shame over what happened (6,8,(12)(13)(14)(15).…”