Mortality in offspring of mothers with psychotic disorder.
BACKGROUND
Previous studies suggest that offspring of mothers with psychotic disorders have an almost two-fold higher mortality risk from birth until early adulthood. We investigated predictors of mortality from late adolescence until middle age in offspring of mothers with psychotic disorders.


METHODS
The Helsinki High-Risk Study follows up offspring (n=337) of women treated for schizophrenia spectrum disorders in mental hospitals in Helsinki before 1975. Factors related to mortality up to 2005 among offspring of these mothers was investigated with a survival model. Hazard rate ratios (HRR) were calculated using sex, diagnosis of psychotic disorder, childhood socio-economic status, maternal diagnosis, and maternal suicide attempts and aggressive symptoms as explanatory variables. The effect of family was investigated by including a frailty term in the model. We also compared mortality between the high-risk group and the Finnish general population.


RESULTS
Within the high-risk group, females had lower all-cause mortality (HRR 0.43, p=0.05) and mortality from unnatural causes (HRR 0.24, p=0.03) than males. Having themselves been diagnosed with a psychotic disorder was associated with higher mortality from unnatural causes (HRR 4.76, p=0.01), while maternal suicide attempts were associated with higher suicide mortality (HRR 8.64, p=0.03). Mortality in the high-risk group was over two-fold higher (HRR 2.44, p<0.0001) than in the general population, and remained significantly higher when high-risk offspring who later developed psychotic disorders were excluded from the study sample (HRR 2.30, p<0.0001).


CONCLUSIONS
Offspring of mothers with psychotic disorder are at increased risk of several adverse outcomes, including premature death.
Suvisaari
J
J
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland. jaana.suvisaari@ktl.fi
Häkkinen
L
L
Haukka
J
J
Lönnqvist
J
J
D000293:Adolescent; D000328:Adult; D046688:Child Mortality / Q000639:trends*; D016241:Child of Impaired Parents / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data*; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology*