People whose parents die when they themselves are under 18 have a higher lifelong risk of suicide, according to research published in JAMA psychology.
Parental death from suicide is known to be linked with mental health problems and increased risk of suicide in the bereaved child, but little is known about the long-term risks of suicide after parental death from other causes.
In Western societies, 3-4% of children experience the death of a parent, established as one of the most stressful and potentially harmful life events in childhood. While most children and adolescents adapt to the loss, others develop preventable social and psychological problems.
In order to gain a better understanding, and with a view to improving suicide prevention efforts, Mai-Britt Guldin, PhD, of Aarhus University, Denmark, and colleagues tracked data for children from three Scandinavian countries for up to 40 years.
They hypothesized that accidental and suicidal death of a parent plus shared genes increase the suicide risk for offspring.
The researchers wanted to look at how risk trajectories may differ by cause of parental death, age of child at time of parental death, sex, time since bereavement, birth order, socioeconomic status and parental psychiatric history.
They used nationwide register data from 1968-2008 in Denmark, Sweden and Finland for a total of 7.3 million individuals, identifying 189,094 children (2.6%) who had a parent die before the child turned 18. These were compared with a control group of people whose parents had not died.
Parental death during childhood was found to be associated with an increased risk of suicide for the offspring, which lasted for at least 25 years after the parent’s death.
Authors found that 265 individuals, or 0.14% of the bereaved group, died from suicide during follow-up, compared with 0.07% of those who did not lose a parent during childhood.
The absolute risk of suicide was 4 in 1,000 persons for boys who experienced parental death in childhood and 2 in 1,000 persons for girls.
- In 2013, suicide was the 10th leading cause of death in the US
- There were 41,149 suicides in 2013, equal to 113 a day or one every 13 minutes
- 33.4% of people committing suicide tested positive for alcohol, 23.8% for antidepressants and 20% for opiates.
The risk of suicide was high for children whose parent died of suicide, but also for those whose parent died of other causes.
Most affected in this study were boys whose mother died of suicide, first-born children and those who had a parent that died before they reached the age of 6.
In contrast, the authors point out that a recent British study reported an increased risk of suicide among later-born children.
If a parent died of suicide, the risk of offspring doing the same was three times greater, as reported in several other studies.
The authors note that the consequences of parental death in childhood are far-reaching, and long-term suicide risk may be influenced by early-life conditions. They call for future public health efforts to consider helping highly distressed children to cope with bereavement.
The team points out that factors such as the highly complex interactions among family members can make preventive efforts difficult.
However, they conclude:
“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.”
Limitations to the study include lack of information on important risk factors, including genetic factors, social network and family lifestyle data. Previous studies have pointed to low socioeconomic status, family history of psychiatric illness, young age at the time of parental death and maternal suicide as risk factors for suicide in people whose parent died when they were young.
In August, Medical News Today reported that risky behavior, psychomotor agitation and impulsivity occur before 50% of suicide attempts in people with depression.