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父母自杀与子女的精神疾病和自杀未遂住院风险。

Maternal or paternal suicide and offspring's psychiatric and suicide-attempt hospitalization risk.

机构信息

Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.

出版信息

Pediatrics. 2010 Nov;126(5):e1026-32. doi: 10.1542/peds.2010-0974. Epub 2010 Oct 18.

Abstract

OBJECTIVE

We examined whether the risk for psychiatric morbidity requiring inpatient care was higher for offspring who experienced parental suicide, compared with offspring of fatal accident decedents, and whether the association varied according to the deceased parent's gender.

METHODS

Children and adolescents (0-17 years of age) who experienced maternal (N = 5600) or paternal (N = 17,847) suicide in 1973-2003 in Sweden were identified by using national, longitudinal, population-based registries. Cox regression modeling was used to compare psychiatric hospitalization risks among offspring of suicide decedents and propensity score-matched offspring of accident decedents.

RESULTS

Offspring of maternal suicide decedents had increased risk of suicide-attempt hospitalization, after controlling for psychiatric hospitalization for decedents and surviving parents, compared with offspring of maternal accidental decedents. Offspring of paternal suicide decedents had similar risk of suicide-attempt hospitalization, compared with offspring of accident decedents, but had increased risk of hospitalization attributable to depressive and anxiety disorders. The magnitude of risks for offspring suicide-attempt hospitalization was greater for those who experienced maternal versus paternal suicide, compared with their respective control offspring (interaction P = .05; offspring of maternal decedents, adjusted hazard ratio: 1.80 [95% confidence interval: 1.19-2.74]; offspring of paternal decedents, adjusted hazard ratio: 1.14 [95% confidence interval: 0.96-1.35]).

CONCLUSIONS

Maternal suicide is associated with increased risk of suicide-attempt hospitalization for offspring, beyond the risk associated with maternal accidental death. However, paternal suicide is not associated with suicide-attempt hospitalization. Future studies should examine factors that might differ between offspring who experience maternal versus paternal suicide, including genetic or early environmental determinants.

摘要

目的

我们研究了经历父母自杀的子女与经历致命意外事故死亡父母的子女相比,是否有更高的精神疾病发病风险需要住院治疗,以及这种关联是否因已故父母的性别而异。

方法

通过使用全国性、纵向、基于人群的登记册,确定了 1973 年至 2003 年间经历母亲(N=5600)或父亲(N=17847)自杀的儿童和青少年(0-17 岁)。使用 Cox 回归模型比较了自杀死者的子女与意外事故死者的匹配倾向得分的子女之间的精神病住院风险。

结果

在控制了死者和幸存父母的精神病住院治疗后,与经历母亲意外死亡的子女相比,经历母亲自杀死亡的子女自杀未遂住院的风险增加。与意外事故死者的子女相比,经历父亲自杀死亡的子女自杀未遂住院的风险相似,但因抑郁和焦虑障碍而住院的风险增加。与经历父亲自杀的子女相比,经历母亲自杀的子女自杀未遂住院的风险更大,与各自的对照子女相比(交互 P=0.05;经历母亲死亡的子女,调整后的危险比:1.80 [95%置信区间:1.19-2.74];经历父亲死亡的子女,调整后的危险比:1.14 [95%置信区间:0.96-1.35])。

结论

母亲自杀与子女自杀未遂住院风险增加有关,超过了与母亲意外死亡相关的风险。然而,父亲自杀与自杀未遂住院无关。未来的研究应该检查经历母亲自杀与经历父亲自杀的子女之间可能存在差异的因素,包括遗传或早期环境决定因素。

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