Parental Death Linked to Increased Suicide Risk Later in Life

Dutch research indicates that parental death during childhood appears to increase long-term risk of suicide among that parent’s children, regardless of the parent’s cause of death. The authors, who had their study published online in JAMA Psychiatry on November 11, write that 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.”

Whereas most of the 3% to 4% of children and adolescents in Western societies who experience the death of a parent adapt to the loss, many develop preventable social and psychological problems that can lead to suicide, according to the study. Mai-Britt Guldin, PhD, in the Research Unit for General Practice at Aarhus University in Denmark, and colleagues felt a better understanding between parental death and suicide in bereaved children may help improve suicide prevention efforts.

For the population-based matched cohort study, the study team reviewed data on 7.3 million individuals from nationwide registries in Denmark, Sweden, and Finland between 1968 and 2008. They identified 189,094 children (2.5%) who had a parent die before the child turned 18 and dubbed this group the bereaved group. Each bereaved child was matched by gender and age to 10 children who did not have a parent who died before the child reached age 18, for a total of 1,890,940 reference group children.

Guldin and colleagues followed both group for up to 40 years. Poisson regression was used to calculate the incidence rate ratio, while accounting for age at parental death, gender, time since bereavement, maternal/paternal death, birth order, family history of psychiatric illness, and socioeconomic status.

During the follow-up period, 265 individuals in the bereaved group (0.14%) and 1,342 individuals in the reference group (0.07%) died from suicide. The incidence rate ratio tended to be higher for those in the bereaved group who had a parent who died before the reached aged 6 years, and the incidence rate ratio remained high for at least 25 years.

Over the 25-year follow-up period, the absolute risk of suicide was four in 1,000 persons for boys in the bereaved group, compared with an absolute risk of two in 1,000 persons for girls. Risk of suicide was high for children whose parent died of suicide, but this risk was also high for children whose parent died of other causes, according to the study authors.

Guldin and colleagues note that the study did not control for such important suicide risk factors as genetics, social network, and family lifestyle.

“Our study points to the early mitigation of distress to reduce the risk of suicidal behavior among children who had a parent who died during childhood,” the study authors write. They suggest that future public health efforts consider helping highly distressed children cope with bereavement.