Brent David, Melhem Nadine, Donohoe M Bertille, Walker Monica
Western Psychiatric Institute and Clinic, Rm. 315, Bellefield Towers, 3811 O'Hara St., Pittsburgh, PA 15213, USA.
Am J Psychiatry. 2009 Jul;166(7):786-94. doi: 10.1176/appi.ajp.2009.08081244. Epub 2009 May 1.
This study examined effects of bereavement 21 months after a parent's death, particularly death by suicide.
The participants were 176 offspring, ages 7-25, of parents who died by suicide, accident, or sudden natural death. They were assessed 9 and 21 months after the death, along with 168 nonbereaved subjects.
Major depression and alcohol or substance abuse 21 months after the parent's death were more common among bereaved youth than among comparison subjects. Offspring with parental suicide or accidental death had higher rates of depression than comparison subjects; those with parental suicide had higher rates of alcohol or substance abuse. Youth with parental suicide had a higher incidence of depression than those bereaved by sudden natural death. Bereavement and a past history of depression increased depression risk in the 9 months following the death, which increased depression risk between 9 and 21 months. Losing a mother, blaming others, low self-esteem, negative coping, and complicated grief were associated with depression in the second year.
Youth who lose a parent, especially through suicide, are vulnerable to depression and alcohol or substance abuse during the second year after the loss. Depression risk in the second year is mediated by the increased incidence of depression within the first 9 months. The most propitious time to prevent or attenuate depressive episodes in bereaved youth may be shortly after the parent's death. Interventions that target complicated grief and blaming of others may also improve outcomes in symptomatic youth with parental bereavement.
本研究调查了父母去世21个月后的丧亲之痛的影响，尤其是自杀死亡后的影响。
参与者为176名年龄在7至25岁之间的父母因自杀、意外或突然自然死亡的子女。在其父母去世9个月和21个月后对他们进行评估，同时评估168名未经历丧亲之痛的受试者。
父母去世21个月后，丧亲的青少年中重度抑郁以及酒精或药物滥用比对照组更常见。父母自杀或意外死亡的子女患抑郁症的比例高于对照组；父母自杀的子女酒精或药物滥用的比例更高。父母自杀的青少年患抑郁症的发生率高于因突然自然死亡而丧亲的青少年。丧亲之痛和过去的抑郁病史会增加死亡后9个月内的抑郁风险，进而增加9至21个月期间的抑郁风险。在第二年，失去母亲、责备他人、自卑、消极应对和复杂悲伤与抑郁有关。
失去父母，尤其是因自杀失去父母的青少年，在丧亲后的第二年易患抑郁症和酒精或药物滥用。第二年的抑郁风险是由前9个月内抑郁症发病率的增加所介导的。预防或减轻丧亲青少年抑郁发作的最佳时机可能是在父母去世后不久。针对复杂悲伤和责备他人的干预措施也可能改善有症状的丧亲青少年的预后。
