title: Parental death in childhood and self-inflicted injuries in young adults-a national cohort study from Sweden.
abstract: Previous studies have shown that parental death influences health and mortality in bereaved offspring. To date, few studies have examined whether exposure to parental bereavement in childhood is associated with suicidality later in life. The aim of the present research was to investigate whether parental death during childhood influences self-inflicted injuries/poisoning in young adulthood. A national cohort born during 1973-1982 (N = 871,402) was followed prospectively in the National Patient Discharge Register from age 18 to 31-40 years. Cox regression analyses of proportional hazards, with adjustment for socio-demographic confounders and parental psychosocial covariates, were used to test hypotheses regarding parental loss and hospital admission due to self-inflicted injuries/poisoning. Parental deaths were divided into deaths caused by (1) external causes/substance abuse and (2) natural causes. Persons who had lost a parent to an external cause/substance abuse-related death had the highest risk of being admitted to a hospital for a self-inflicted injury/poisoning; HRs 2.03 (1.67-2.46) for maternal death and 2.03 (1.84-2.25) for paternal death, after adjustment for socio-demographic confounders and risk factors among surviving parents. Risks were also increased for parental death due to natural causes, but at a lower level: 1.19 (1.01-1.39) and 1.28 (1.15-1.43), respectively. Losing a father before school age was associated with a higher risk of hospital admission for a self-inflicted injury/poisoning than was loss at an older age for both genders. Maternal loss before school age was associated with a higher risk only for men, particularly maternal death by natural causes (p < 0.01).
authors.affiliation: Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Sveavägen 160, 10691, Stockholm, Sweden. mikael.rostila@chess.su.se.
authors.forename: Mikael
authors.initials: M
authors.lastname: Rostila
authors.affiliation: Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Sveavägen 160, 10691, Stockholm, Sweden.
authors.forename: Lisa
authors.initials: L
authors.lastname: Berg
authors.affiliation: Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Sveavägen 160, 10691, Stockholm, Sweden.
authors.forename: Arzu
authors.initials: A
authors.lastname: Arat
authors.affiliation: Department of Social Work, Stockholm University, Stockholm, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Vinnerljung
authors.affiliation: Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Sveavägen 160, 10691, Stockholm, Sweden.|Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Hjern
mesh_terms: D000293:Adolescent; D000328:Adult; D001601:Bereavement; D002423:Cause of Death; D015331:Cohort Studies; D005190:Family; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D063129:Parental Death / Q000523:psychology*; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology*; D013548:Sweden; D055815:Young Adult
keywords: Bereavement; Registry data; Self-inflicted injuries; Suicide; Sweden