Burrell Lisa Victoria, Mehlum Lars, Qin Ping
National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway.
Child Adolesc Ment Health. 2022 May;27(2):122-130. doi: 10.1111/camh.12470. Epub 2021 May 4.
Previous studies have reported increased risks of psychiatric disorders in offspring who have lost a parent, but knowledge is lacking on the risks of several specific disorders and comorbidity. The present study investigated the influence of parental death by external causes during childhood and adolescence on risk of a range of psychiatric disorders and comorbidity.
The study cohort comprised 655,477 individuals born 1970-2012 with a link to both parents. Data on deceased parent's cause and date of death between 1970 and 2012 and offspring's psychiatric disorders between 2008 and 2012 were retrieved from four longitudinal Norwegian registers. Data were analyzed with Cox regression.
Compared to nonexposed offspring, offspring exposed to parental death by external causes had a significantly increased risk of depressive disorders, reactions to stress, anxiety disorders, substance use disorders, developmental disorders, childhood behavioral and emotional disorders, psychotic disorders, bipolar disorder, personality disorders, and psychiatric comorbidity, but not eating disorders. These increased risks were especially evident following parental suicide and accidental falls and poisoning. No differences were evident depending on gender of the deceased or age at bereavement, and generally no significant interactions with gender of the bereaved offspring were evident.
The improved insight into several different psychiatric disorders and psychiatric comorbidity should guide postvention measures aimed at children and adolescents at greatest risk of future sequelae.
既往研究报告称，失去双亲的后代患精神疾病的风险增加，但对于几种特定疾病及共病的风险了解不足。本研究调查了童年和青少年时期因外部原因导致的父母死亡对一系列精神疾病及共病风险的影响。
研究队列包括1970年至2012年出生且与双亲均有联系的655477人。从挪威四个纵向登记处获取了1970年至2012年期间已故父母的死因和死亡日期以及2008年至2012年期间后代精神疾病的数据。采用Cox回归分析数据。
与未暴露的后代相比，因外部原因经历父母死亡的后代患抑郁症、应激反应、焦虑症、物质使用障碍、发育障碍、儿童行为和情绪障碍、精神分裂症、双相情感障碍、人格障碍及精神共病的风险显著增加，但饮食失调风险未增加。这些增加的风险在父母自杀、意外跌倒和中毒后尤为明显。根据已故者的性别或丧亲时的年龄，未发现明显差异，并且一般来说，与丧亲后代的性别也没有明显的显著相互作用。
对几种不同精神疾病及精神共病的深入了解应指导针对未来后遗症风险最大的儿童和青少年的善后措施。
