Exposure to parental mortality and markers of morbidity, and the risks of attempted and completed suicide in offspring: an analysis of sensitive life periods
- Thomas Niederkrotenthaler1,
- Birgitta Floderus2,
- Kristina Alexanderson3,
- Finn Rasmussen4,
- Ellenor Mittendorfer-Rutz5
- 1Department of General Practice and Family Medicine & Institute for Medical Psychology, Center for Public Health, Medical University of Vienna, Vienna, Austria
- 2Karolinska Institutet, Department of Public Health Sciences, National Prevention of Suicide and Mental Ill-Health (NASP) and Department of Clinical Neuroscience, Division of Insurance Medicine, Stockholm, Sweden
- 3Karolinska Institutet, Department of Clinical Neuroscience, Division of Insurance Medicine, Stockholm, Sweden
- 4Karolinska Institutet, Department of Public Health Sciences, Child and Adolescent Public Health Epidemiology, Stockholm, Sweden
- 5Karolinska Institutet, Department of Clinical Neuroscience, Division of Insurance Medicine, Stockholm, Sweden
- Correspondence to Thomas Niederkrotenthaler, Department of General Practice and Family Medicine & Institute for Medical Psychology, Center for Public Health, Medical University of Vienna, Severingasse 9, 1090 Vienna, Austria;
- Accepted 17 July 2010
- Published Online First 5 October 2010
Background There is evidence of parental risk factors for suicidal behaviour in offspring, but research on variations in their effects with offspring's age at first exposure is sparse.
Aims To explore the effects of age at exposure to parental mortality and markers of morbidity on the risks of suicide and attempted suicide in offspring.
Methods This was a case–control study effected through record linkage between Swedish registers. Individuals born 1973–83 who committed suicide (n=1407) or were hospitalised due to an attempted suicide (n=17 159) were matched to ≤10 controls by sex, month and county of birth. ORs were measured in time windows representing age at first exposure.
Results A general pattern of increasing risks of suicide and attempted suicide in offspring with decreasing age at exposure to parental risk factors emerged. Adjusted suicide risk (OR (95% CI)) was most pronounced in the youngest exposure window for parental psychiatric disability pension (3.1 (1.6 to 5.8)), somatic disability pension (1.9 (1.0 to 3.4)), psychiatric inpatient care (2.5 (2.0 to 3.1)), parental attempted suicide (2.9 (2.0 to 4.1)) and suicide (2.9 (1.7 to 5.2)). For parental non-suicidal deaths, the general pattern was the opposite. Patterns in offspring attempted suicide were similar to completed suicide for parental disability pension, psychiatric inpatient care and non-suicidal death. Attempted suicide risk after parental suicide showed an increasing trend with increasing age at exposure.
Conclusion Parental morbidity and parental suicidal behaviour show the most detrimental effects on completed suicide among offspring when they appear early in life. Early interventions in families at risk are necessary to prevent suicide in offspring.
- life course epidemiology
- matched case control study
- case control me
- parents CG
- suicide SI
- youth CG
Funding We thank the Austrian Academy of Sciences for funding the project through a DOC-team scholarship (grant number 70034 to TN) and the Swedish Council for Working Life and Social Research (KA and EMR).
Competing interests None.
Ethics approval The study was approved by the Research Ethics Committee in Stockholm, Sweden.
Provenance and peer review Not commissioned; externally peer reviewed.