Department of Global Public Health, Karolinska Institutet, Solnavägen 1C, 113 65, Stockholm, Sweden.
Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Soc Psychiatry Psychiatr Epidemiol. 2022 Nov;57(11):2241-2250. doi: 10.1007/s00127-022-02321-y. Epub 2022 Jul 15.
Previous studies suggest a protective effect of parenthood on suicide, but little is known about how the association may change across the lifespan, or in relation to sex, marital status or occurrence of psychiatric disorders.
We followed a cohort of over 5 million Swedish women and men, from 1991 to 2011, up to max. age 75, for death by suicide using national registers. Information on childbirths/adoptions, potential confounders and modifying factors were obtained from national registers. We assessed the associations between parenthood and suicide across adulthood using within time-stratified Cox regression models, with parenthood as a time-dependent exposure.
Parents had a lower risk of suicide than non-parents across the lifespan, after adjusting for sociodemographic factors. The association was most pronounced in young adults, especially young women, but attenuated with increasing age and converged between sexes in older age groups. The lower risk of suicide over the life course was similar whether parents were married, unmarried or divorced, apart from married men; among them, parents only had a lower risk above age 55. The lower risk in parents was also evident in people with a history of psychiatric hospitalizations, but disappeared from age 55 in this population.
The lower risk of suicide was present in both parents, was most pronounced in young adulthood and weakened with increasing age. Our results are consistent with a plausible mechanism where feelings of responsibility and connectedness are protective against suicide in parents.
先前的研究表明为人父母对自杀有保护作用,但人们对这种关联如何随年龄变化,或与性别、婚姻状况或精神障碍的发生有关知之甚少。
我们对超过 500 万瑞典男女进行了队列研究,从 1991 年到 2011 年,随访至最大年龄 75 岁,使用国家登记处记录自杀死亡情况。通过国家登记处获取了关于生育/收养、潜在混杂因素和调节因素的信息。我们使用时间分层 Cox 回归模型,在整个成年期评估了为人父母与自杀之间的关联,将为人父母作为时间依赖性暴露因素。
在调整了社会人口因素后,父母在整个生命周期中的自杀风险均低于非父母。这种关联在年轻成年人中最为明显,尤其是年轻女性,但随着年龄的增长而减弱,在老年人群中男女之间的差异缩小。在整个生命过程中,自杀风险的降低与父母是否已婚、未婚或离婚无关,但在已婚男性中,只有在 55 岁以上时才会降低。在有精神科住院史的人群中,父母的自杀风险也较低,但在该人群中,这种风险从 55 岁开始消失。
自杀风险降低在父母中均存在,在成年早期最为明显,随着年龄的增长而减弱。我们的研究结果与一种合理的机制一致,即责任感和归属感可能对父母的自杀行为具有保护作用。