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Psychological morbidity among suicide-bereaved and non-bereaved parents: a nationwide population survey
Karolinska Institutet.ORCID iD: 0000-0003-1835-1960
Karolinska Institutet; Sahlgrenska akademin Göteborgs universitet.
Sahlgrenska akademin Göteborgs universitet.
Karolinska Institutet.
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2013 (English)In: BMJ Open, ISSN 2044-6055, Vol. 3, no 8, e003108Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To determine how psychological premorbidity affects the risk of depression in parents who lost a child through suicide.

DESIGN: Population-based survey.

SETTING: Sweden, between 2009 and 2010.

PARTICIPANTS: All parents who lost a child, age 15-30, through suicide between 2004 and 2007 according to National population registries. Non-bereaved parents matched for age, sex, living area, marital status, number of children.

EXCLUSION CRITERIA: born outside a Nordic country, not Swedish speaking, contact details missing. Participants: 666 of 915 (73%) suicide-bereaved and 377 of 508 (74%) non-bereaved parents.

MAIN OUTCOME MEASURES: Depression measured by the nine-item depression scale of the Patient Health Questionnaire (PHQ-9) and study-specific questions to assess psychological premorbidity and experience of the child's presuicidal morbidity.

RESULTS: In all, 94 (14%) suicide-bereaved and 51 (14%) non-bereaved parents (relative risk 1.0; 95% CI 0.8 to 1.4) had received their first treatment for psychological problems or had been given a psychiatric diagnosis more than 10 years earlier. The prevalence of moderate-to-severe depression was 115 (18%) in suicide-bereaved versus 28 (7%) in non-bereaved parents (RR 2.3; 95% CI 1.6 to 3.5). For those without psychological premorbidity, the relative risk was 2.3 (95% CI 1.4 to 3.6). 339 (51%) suicide-bereaved parents expressed worry over the child's psychological health during the month preceding the suicide and 259 (39%) had anticipated the suicide.

CONCLUSIONS: In parents who lost a child through suicide in Sweden we did not find a higher prevalence of long-term psychological premorbidity than among parents who had not lost a child; the more than twofold risk of depression among the bereaved can probably be explained by the suicide and the stressful time preceding the suicide.

Place, publisher, year, edition, pages
2013. Vol. 3, no 8, e003108
National Category
Other Medical Sciences not elsewhere specified
URN: urn:nbn:se:esh:diva-4127DOI: 10.1136/bmjopen-2013-003108PubMedID: 23996818OAI: diva2:755550

Funding The study was supported by The Swedish Council for Working Life Social Research (FAS), ALF Grants, County Council of Stockholm and Swedish Lundbeck foundation

Available from: 2014-10-14 Created: 2014-10-14 Last updated: 2015-09-18Bibliographically approved
In thesis
1. Parents who have lost a son or daughter through suicide: towards improved care and restored psychological health
Open this publication in new window or tab >>Parents who have lost a son or daughter through suicide: towards improved care and restored psychological health
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background Parents that have lost a son or daughter through suicide are at risk of developing psychological morbidity that may become long-lasting and even life-threatening. Despite this the aftermath of a suicidal loss is yet to be carefully studied. One reason for the lack of studies is that trauma-related surveys may be hindered when the risks of asking participants are overestimated and the benefits not considered. Another reason is methodological difficulties. The goal of our studies is to provide knowledge that may be used to improve the professional care of suicide-bereaved parents. This thesis describes the first steps towards the goal.

Methods We developed hypotheses, questionnaires and an ethical protocol in a qualitative preparatory study with 46 suicide-bereaved parents (paper I). In a population-based survey we then collected data from parents who lost a child (15 to 30 years of age) to suicide, two to five years earlier. In all, 666 of 915 (73%) bereaved and 508 of 666 (74%) non-bereaved (matched 2:1) parents participated.

Results We found that 633 (95%) of the bereaved parents thought the study was valuable and that 604 (91%) would recommend another parent to participate. Among the bereaved 334 (50%) reported being positively affected by their participation, whereas 70 (11%) reported being temporary negatively affected (most referring to sadness). The bereaved parents’ need for sharing their experiences regarding the suicide of their child was widely expressed and 639 (96%) thought the healthcare should contact parents bereaved through suicide to offer information and support (paper II). In all, 167 (25%) of the bereaved parents were currently taking antidepressants or were moderate-to severely depressed according to PHQ-9 versus 35 (9%) of the non-bereaved (RR 2.7). Fourteen percent of the bereaved reported they had had psychological morbidity more than 10 years earlier, versus 14% among the non-bereaved (RR 1.0). The highest levels of current psychological morbidity were found among the group of bereaved parents with psychological premorbidity (paper III). Of the bereaved parents 460 had (69%) viewed the body at a formal setting, among these parents 430 of 446 (96%) answered “no” to the question “Do you regret that you viewed your child after the death”. Among the parents that had not viewed 99 of 159 (62%) answered “no” to the question “Do you wish that you had viewed your child after the death” (paper IV).

Conclusions We found that most parents perceived the research participation as something positive and that the contact was welcomed. Bereavement was associated with high prevalence of psychological morbidity two to five years after the loss. We found no difference in prevalence of premorbidity between the bereaved and the non-bereaved parents. The significant minority that had premorbidity before the loss did however report the highest levels of current psychological morbidity. By and large everyone that had viewed their deceased child in a formal setting did not regret the viewing. Of equal importance, more than half of those who did not view the body did not wish that they had.

Place, publisher, year, edition, pages
Stockholm: Karolinska institutet, 2014. 85 p.
National Category
Research subject
urn:nbn:se:esh:diva-4816 (URN)9789175492827 (ISBN)
Public defence
2014-01-20, 10:00
Available from: 2015-09-18 Created: 2015-08-31 Last updated: 2015-09-18Bibliographically approved

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