Substance use disorder and suicide-related behaviour around dates of parental death and its anniversaries: a register-based cohort study

Hiyoshi, Ayako; Berg, Lisa; Saarela, Jan; Fall, Katja; Grotta, Alessandra; Shebehe, Jacques; Kawachi, Ichiro; Rostila, Mikael; Montgomery, Scott

doi:10.1016/s2468-2667(22)00158-x

Cited by 9 publications

(40 citation statements)

References 48 publications

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“…Consistent with previous studies, 5,12,15 our findings showed clear differences in anniversary reactions between men and women. Our results suggest that anniversaries may trigger grief among women, but we did not find any evidence of an anniversary reaction among men, but rather a decreased risk of suicide.…”

Section: Jama Network Open | Psychiatrysupporting

confidence: 93%

“…Moreover, previous studies have often investigated how the overall risk change within a 1-month period around the anniversary, without differentiating between preanniversary or postanniversary increases in the risk . Using a case-crossover design on a large national sample, our study was able to investigate periods that were associated with a higher risk of suicide before and after the anniversary, in line with a previous study focusing on younger individuals …”

Section: Discussionsupporting

confidence: 52%

“…Our results suggest that anniversaries may trigger grief among women, but we did not find any evidence of an anniversary reaction among men, but rather a decreased risk of suicide. Analogous differences between men and women have been observed in the mortality risk among parents who lost a child and in suicide-related behavior among children and youths who lost a parent . We could speculate that women have stronger relationships with their parents, potentially relating to caregiver roles that women assume more often than men .…”

Section: Discussionmentioning

confidence: 75%

“…13,15 Using a case-crossover design on a large national sample, our study was able to investigate periods that were associated with a higher risk of suicide before and after the anniversary, in line with a previous study focusing on younger individuals. 5 Although the loss of a parent during childhood has received attention in previous research, bereavement following the loss of a parent experienced during adulthood has been largely overlooked. Even though losing a parent during adulthood is an expected event, it does not necessarily imply that the offspring's psychological and physical health will be unaffected.…”

Section: Jama Network Open | Psychiatrymentioning

confidence: 99%

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Suicide Around the Anniversary of a Parent’s Death in Sweden

et al. 2023

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ImportanceBereavement following parental death experienced in adulthood may be associated with suicide over many years, but this risk has received scant attention.ObjectiveTo investigate whether the risk of suicide increases among adult children around the anniversary of a parent’s death.Design, Setting, and ParticipantsThis case-crossover study used Swedish register-based longitudinal data from 1990 to 2016, based on the entire national population. Participants included all adults aged 18 to 65 years who experienced parental death and subsequently died by suicide. Conditional logistic regression was used to quantify the association between the anniversary (or preanniversary and postanniversary periods) and suicide, controlling for time-invariant confounding. All analyses were stratified by sex of the offspring. The analyses were also stratified by the sex of the deceased parent, time since parental death, age, and marital status. Data analyses were performed in June 2022.ExposuresAnniversary of a parent’s death (or preanniversary and postanniversary periods).Main Outcomes and MeasuresSuicide.ResultsOf 7694 individuals who died by suicide (76% intentional self-harm), 2255 (29%) were women, and the median (IQR) age at suicide was 55 (47-62) years. There was evidence of an anniversary reaction among women, with a 67% increase in the odds of suicide when exposed to the period from the anniversary to 2 days after the anniversary, compared with when not being exposed (odds ratio [OR], 1.67; 95% CI, 1.07-2.62). The risk was particularly pronounced among maternally bereaved women (OR, 2.29; 95% CI, 1.20-4.40) and women who were never married (OR, 2.08; 95% CI, 0.99-4.37), although the latter was not statistically significant. An increased risk of suicide from the day before up to the anniversary was observed among women bereaved between the ages of 18 and 34 years (OR, 3.46; 95% CI, 1.14-10.56) and between the ages of 50 and 65 years (OR, 2.53; 95% CI, 1.04-6.15). Men had an attenuated suicide risk for the period from the day before up to the anniversary (OR, 0.57; 95% CI, 0.36-0.92).Conclusions and RelevanceThese findings suggest that the anniversary of a parent’s death is associated with an increased suicide risk among women. Women bereaved at younger or older ages, those who were maternally bereaved, and those who never married appeared to be particularly vulnerable. Families and social and health care professionals need to consider anniversary reactions in suicide prevention.

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Section: Jama Network Open | Psychiatrysupporting

confidence: 93%

Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 75%

Section: Jama Network Open | Psychiatrymentioning

confidence: 99%

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Suicide Around the Anniversary of a Parent’s Death in Sweden

et al. 2023

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“…In a study by Ayako Hiyoshi and colleagues, 4 adolescents and young adults of deceased parents were found to have a higher risk of suicide-related behaviour (ie, suicide attempts or death by suicide around the date of death and the first anniversary of parental death) than were non-bereaved peers. 4 A comparable level of excess risk was found in hospitalisation and deaths due to substance use. Among girls and women who were bereaved, higher risks of suicide-related behaviour and substance use disorder continued to be seen during the months of later anniversaries compared with other months.…”

mentioning

confidence: 85%

Are young people more vulnerable at anniversaries of deceased parents' death dates?

Erlangsen

2022

The Lancet Public Health

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Estimated Number of Children Who Lost a Parent to Drug Overdose in the US From 2011 to 2021

Jones,

Zhang,

Han

et al. 2024

JAMA Psychiatry

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ImportanceParents’ overdose death can have a profound short- and long-term impact on their children, yet little is known about the number of children who have lost a parent to drug overdose in the US.ObjectiveTo estimate the number and rate of children who have lost a parent to drug overdose from 2011 to 2021 overall and by parental age, sex, and race and ethnicity.Design, Setting, and ParticipantsThis was a cross-sectional study of US community-dwelling persons using data from the National Survey on Drug Use and Health (2010-2014 and 2015-2019) and the National Vital Statistics System (2011-2021). Data were analyzed from January to June 2023.ExposureParental drug overdose death, stratified by age group, sex, and race and ethnicity.Main Outcomes and MeasuresNumbers, rates, and average annual percentage change (AAPC) in rates of children losing a parent aged 18 to 64 years to drug overdose, overall and by age, sex, and race and ethnicity.ResultsFrom 2011 to 2021, 649 599 adults aged 18 to 64 years died from a drug overdose (mean [SD] age, 41.7 [12.0] years; 430 050 [66.2%] male and 219 549 [33.8%] female; 62 606 [9.6%] Hispanic, 6899 [1.1%] non-Hispanic American Indian or Alaska Native, 6133 [0.9%] non-Hispanic Asian or Pacific Islander, 82 313 [12.7%] non-Hispanic Black, 485 623 [74.8%] non-Hispanic White, and 6025 [0.9%] non-Hispanic with more than 1 race). Among these decedents, from 2011 to 2021, an estimated 321 566 (95% CI, 276 592-366 662) community-dwelling children lost a parent aged 18 to 64 years to drug overdose. The rate of community-dwelling children who lost a parent to drug overdose per 100 000 children increased from 27.0 per 100 000 in 2011 to 63.1 per 100 000 in 2021. The highest rates were found among children of non-Hispanic American Indian or Alaska Native individuals, who had a rate of 187.1 per 100 000 in 2021, more than double the rate among children of non-Hispanic White individuals (76.5 per 100 000) and non-Hispanic Black individuals (73.2 per 100 000). While rates increased consistently each year for all parental age, sex, and race and ethnicity groups, non-Hispanic Black parents aged 18 to 25 years had the largest AAPC (23.8%; 95% CI, 16.5-31.6). Rates increased for both fathers and mothers; however, more children overall lost fathers (estimated 192 459; 95% CI, 164 081-220 838) than mothers (estimated 129 107; 95% CI, 112 510-145 824).Conclusions and RelevanceAn estimated 321 566 children lost a parent to drug overdose in the US from 2011 to 2021, with significant disparities evident across racial and ethnic groups. Given the potential short- and long-term negative impact of parental loss, program and policy planning should ensure that responses to the overdose crisis account for the full burden of drug overdose on families and children, including addressing the economic, social, educational, and health care needs of children who have lost parents to overdose.

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Substance use disorder and suicide-related behaviour around dates of parental death and its anniversaries: a register-based cohort study

Cited by 9 publications

References 48 publications

Suicide Around the Anniversary of a Parent’s Death in Sweden

Suicide Around the Anniversary of a Parent’s Death in Sweden

Are young people more vulnerable at anniversaries of deceased parents' death dates?

Estimated Number of Children Who Lost a Parent to Drug Overdose in the US From 2011 to 2021

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