Risk of death by unnatural causes during early childhood in offspring of parents with mental illness.
OBJECTIVE
Limited evidence reveals an elevated mortality risk in offspring of psychiatric patients after infancy. This nationwide population-based study in Taiwan aimed to investigate mortality risk in preschool children up to age 5 whose parents have severe mental illness.


METHODS
Three nationwide population-based data sets were linked. A total of 3,166 children with one or both parents having schizophrenia or an affective disorder were identified, together with a comparison cohort of 25,328 children matched with the study group in terms of maternal age and year of delivery. Cox proportional hazard regressions were performed to compute hazard ratios, with adjustment for sociodemographic characteristics and maternal medical comorbidities.


RESULTS
During the preschool years, 54 (1.7%) deaths were documented among offspring of parents with severe mental illness and 155 (0.6%) in the comparison cohort. Parental mental illness was independently associated with a risk of death nearly 2.4 times higher (95% CI=1.72-3.28) than in the comparison cohort. The association was even more marked for unnatural causes of death, in which the mortality risk was 8.35 times greater (95% CI=4.04-17.24) in children of affected parents than in the comparison cohort. The proportional mortality rates were as high as 20.4% and 11.1% for accident and homicide, respectively, among offspring exposed to parental mental illness.


CONCLUSIONS
An elevated mortality risk, especially from unnatural causes of death, was identified for offspring of parents with severe mental illness during the preschool years in an Asian society. There is an urgent need for multidisciplinary team approaches and risk management strategies to support psychiatric patients who are having difficulty with the transition to parenthood.
Chen
Yi-Hua
YH
School of Health Care Administration, Taipei Medical University, 250 Wu-Hsing St., Taipei 110, Taiwan.
Chiou
Hung-Yi
HY
Tang
Chao-Hsiun
CH
Lin
Herng-Ching
HC
D000059:Accidents / Q000401:mortality; D000328:Adult; D046688:Child Mortality; D016241:Child of Impaired Parents / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015331:Cohort Studies; D005220:Fathers; D005260:Female; D006708:Homicide / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D001523:Mental Disorders; D009035:Mothers; D016016:Proportional Hazards Models; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult