FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 352:1190-1196 March 24, 2005 Number 12 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background The loss of a child is considered one of the most stressful events in the life of a parent. We hypothesized that parental bereavement increases the risk of hospital admission for a psychiatric disorder, especially for affective disorders.

Methods We studied a cohort of 1,082,503 persons identified from national registers in Denmark who were born between 1952 and 1999 and had at least one child under 18 years of age during the follow-up period, from 1970 to 1999. Parents who lost a child during follow-up were categorized as "bereaved" from the date of death of the child.

Results As compared with parents who did not lose a child, parents who lost a child had an overall relative risk of a first psychiatric hospitalization for any disorder of 1.67 (95 percent confidence interval, 1.53 to 1.83). Bereaved mothers had a higher relative risk of being hospitalized for any psychiatric disorder than bereaved fathers (relative risks, 1.78 [95 percent confidence interval, 1.60 to 1.98] and 1.38 [95 percent confidence interval, 1.17 to 1.63], respectively; P value for interaction, 0.01). The relative risks of hospitalization specifically for affective disorders were 1.91 (95 percent confidence interval, 1.59 to 2.30) and 1.61 (95 percent confidence interval, 1.15 to 2.27) for bereaved mothers and fathers, respectively. Among mothers, the relative risk of being hospitalized for any psychiatric disorder was highest during the first year after the death of the child but remained significantly elevated five years or more after the death.

Conclusions The risk of psychiatric hospitalization was increased among parents, especially mothers, who lost a child.

Source Information

From the Danish Epidemiology Science Center, Department of Epidemiology and Social Medicine (J.L., J.O.) and the National Center for Register-Based Research (T.M.L., P.B.M.), University of Aarhus, Aarhus, Denmark; and the Clinical Unit of Preventive Medicine and Health Promotion, Bispebjerg Hospital, Copenhagen (D.H.P.).

Address reprint requests to Dr. Olsen at the Department of Epidemiology, School of Public Health, UCLA, Box 951772, Los Angeles, CA 90095-1772, or at jo{at}ucla.edu.

Full Text of this Article

This article has been cited by other articles:

• Li, J., Vestergaard, M., Obel, C., Christensen, J., Precht, D. H., Lu, M., Olsen, J. (2009). A Nationwide Study on the Risk of Autism After Prenatal Stress Exposure to Maternal Bereavement. Pediatrics 123: 1102-1107 [Abstract] [Full Text]  
• King-Hele, S, Webb, R T, Mortensen, P B, Appleby, L, Pickles, A, Abel, K M (2009). Risk of stillbirth and neonatal death linked with maternal mental illness: a national cohort study. Arch. Dis. Child. Fetal Neonatal Ed. 94: F105-F110 [Abstract] [Full Text]  
• Fang, F., Ye, W., Fall, K., Lekander, M., Wigzell, H., Sparen, P., Adami, H.-O., Valdimarsdottir, U. (2008). Loss of a Child and the Risk of Amyotrophic Lateral Sclerosis. Am J Epidemiol 167: 203-210 [Abstract] [Full Text]  
• King-Hele, S. A., Abel, K. M., Webb, R. T., Mortensen, P. B., Appleby, L., Pickles, A. R. (2007). Risk of Sudden Infant Death Syndrome With Parental Mental Illness. Arch Gen Psychiatry 64: 1323-1330 [Abstract] [Full Text]  
• Furst, B. A. (2007). Bowlby Goes to the Movies: Film as a Teaching Tool for Issues of Bereavement, Mourning, and Grief in Medical Education. Acad. Psychiatry 31: 407-410 [Full Text]  
• Webb, R. T., Pickles, A. R., Appleby, L., Mortensen, P. B., Abel, K. M. (2007). Death by Unnatural Causes During Childhood and Early Adulthood in Offspring of Psychiatric Inpatients. Arch Gen Psychiatry 64: 345-352 [Abstract] [Full Text]  
• Webb, R. T., Abel, K. M., Pickles, A. R., Appleby, L., King-Hele, S. A., Mortensen, P. B. (2006). Mortality Risk Among Offspring of Psychiatric Inpatients: A Population-Based Follow-Up to Early Adulthood. Am. J. Psychiatry 163: 2170-2177 [Abstract] [Full Text]  
• Hunt, H., Valdimarsdottir, U., Mucci, L., Kreicbergs, U., Steineck, G. (2006). When death appears best for the child with severe malignancy: a nationwide parental follow-up. Palliat Med 20: 567-577 [Abstract]  
• Robinson, M. R., Thiel, M. M., Backus, M. M., Meyer, E. C. (2006). Matters of Spirituality at the End of Life in the Pediatric Intensive Care Unit. Pediatrics 118: e719-e729 [Abstract] [Full Text]  
• Vahtera, J., Kivimaki, M., Vaananen, A., Linna, A., Pentti, J., Helenius, H., Elovainio, M. (2006). Sex differences in health effects of family death or illness: are women more vulnerable than men?. Psychosom. Med. 68: 283-291 [Abstract] [Full Text]  
• Christakis, N. A., Allison, P. D. (2006). Mortality after the Hospitalization of a Spouse. NEJM 354: 719-730 [Abstract] [Full Text]  
• (2005). Other articles noted. Evid. Based Ment. Health 8: 94-94 [Full Text]  
• Bratton, S. L. (2005). Parental Mental Illness after the Death of a Child. AAP Grand Rounds 14: 17-17 [Full Text]  
• (2005). Lucina. Arch. Dis. Child. 90: 880-880 [Full Text]  
• (2005). The Burden of Parental Bereavement. JWatch Psychiatry 2005: 2-2 [Full Text]