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Parental death during childhood predicts self-inflicted injuries in young adults-a Swedish national cohort study
Previous studies have suggested that parental loss is associated with increased risk for major depression, but much less is known about the importance of age at the loss and gender differences for the risk of suicidality. We investigated parental death during childhood as a risk factor for self-inflicted injuries/poisoning in young adulthood.
Methods
A national cohort born during 1973-1981 (N=871 402) was followed prospectively in the National Patient Discharge Register from 18 to 30-35 years of age. Multivariate Cox analyses of proportional hazards were used to test hypotheses regarding parental loss and hospital admission due to self-inflicted injuries/poisoning with adjustment for socio-demographic confounders and parental psychosocial covariates. Parental deaths were divided into deaths caused by (1) external causes /substance abuse and (2) natural causes.
Results
Persons who had lost a parent to an external cause/substance abuse death had the highest risk for being admitted to a hospital because of a self-inflicted injury/poisoning; HR:s 2.58 (2.12-3.13) for maternal death and 2.42 (2.19-2.67) for paternal death, after adjustment for socio-demographic confounders. Risks were also increased for parental death because of natural causes, but on a lower level; 1.26 (1.08-1.48) and 1.35 (1.21-1.51) respectively. Adjusting for psychosocial co-variates of the surviving parent decreased these risk estimates slightly.
Losing a father before school age carried a higher risk for a hospital admission because of a self/inflicted injury/poisoning than loss at older ages for both genders. Maternal loss before school age, however, was only associated with a higher risk in men, and for maternal death by natural causes this risk was elevated only for men, but not for women (p<0.01).
Conclusion
Parental death during childhood predicts self-inflicted injuries/poisoning in young adulthood, particularly if the death is caused by deaths associated with familial risk factors preceding the death, such as external or substance abuse. Men are more vulnerable to maternal loss before school age compared with women.
Learning Areas:
EpidemiologySocial and behavioral sciences
Learning Objectives:
Assess parental death during childhood as a risk factor for self-inflicted injuries/poisoning in young adulthood.
Keyword(s): Epidemiology, Suicide
Qualified on the content I am responsible for because: I am the corresponding author of the manuscript and the study has received ethical approval
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.