title: Parents bereaved by offspring suicide: a population-based longitudinal case-control study.
abstract: CONTEXT Suicide bereavement remains understudied and poorly understood. OBJECTIVES To examine outcomes of parents bereaved by the suicide death of their offspring and to compare these with both nonbereaved parent controls and parents who had offspring die in a motor vehicle crash (MVC). DESIGN Population-based case-control study. Suicide-bereaved parents were compared with nonbereaved matched control parents in the general population (n = 1415) and with MVC-bereaved parents (n = 1132) on the rates of physician-diagnosed mental and physical disorders, social factors, and treatment use in the 2 years after death of the offspring. Adjusted relative rates (ARRs) were generated by generalized estimating equation models and adjusted for confounding factors. SETTING Manitoba, Canada. PARTICIPANTS All identifiable parents who had an offspring die by suicide between 1996 and 2007 (n = 1415). MAIN OUTCOME MEASURES Mental and physical disorders, social factors, and treatment use. RESULTS Suicide bereavement was associated with an increased rate of depression (ARR, 2.14; 95% CI, 1.88-2.43), anxiety disorders (ARR, 1.41; 95% CI, 1.24-1.60), and marital breakup (ARR, 1.18; 95% CI, 1.13-1.23) in the 2 years after the suicide of an offspring, as compared with the 2 years prior to the death. Suicide-bereaved and MVC-bereaved parents had very few differences on predeath to postdeath outcomes. Depression rate increases were greater for MVC-bereaved parents (19.9%) compared with suicide-bereaved parents (15.9%; P = .005), whereas suicide-bereaved parents had higher rate increases of hospitalization for mental illness (P = .049). Suicide-bereaved parents were more likely than their MVC-bereaved counterparts to have depression (ARR, 1.30; 95% CI, 1.06-1.61), physical disorders (ARR, 1.32; 95% CI, 1.19-1.45), and low income (ARR, 1.34; 95% CI, 1.18-1.51) before their offspring's death. CONCLUSIONS Suicide bereavement is associated with adverse mental health and social outcomes. These consequences appear similar to those associated with MVC bereavement. Parents who lose offspring to suicide appear to be a vulnerable group even prior to their offspring's death.
authors.affiliation: Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada. jbolton@hsc.mb.ca
authors.forename: James M
authors.initials: JM
authors.lastname: Bolton
authors.forename: Wendy
authors.initials: W
authors.lastname: Au
authors.forename: William D
authors.initials: WD
authors.lastname: Leslie
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Martens
authors.forename: Murray W
authors.initials: MW
authors.lastname: Enns
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Roos
authors.forename: Laurence Y
authors.initials: LY
authors.lastname: Katz
authors.forename: Holly C
authors.initials: HC
authors.lastname: Wilcox
authors.forename: Annette
authors.initials: A
authors.lastname: Erlangsen
authors.forename: Dan
authors.initials: D
authors.lastname: Chateau
authors.forename: Randy
authors.initials: R
authors.lastname: Walld
authors.forename: Rae
authors.initials: R
authors.lastname: Spiwak
authors.forename: Monique
authors.initials: M
authors.lastname: Seguin
authors.forename: Katherine
authors.initials: K
authors.lastname: Shear
authors.forename: Jitender
authors.initials: J
authors.lastname: Sareen
mesh_terms: D000063:Accidents, Traffic / Q000523:psychology / Q000706:statistics & numerical data; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001601:Bereavement; D016022:Case-Control Studies; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D003627:Data Interpretation, Statistical; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005190:Family; D005260:Female; D054624:Health Status Disparities; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D018986:Motor Vehicles; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D000928:Antidepressive Agents