Risk of deliberate self-harm and suicide in children bereaved from parental death by specific natural and external causes - A national study

Abstract

Objective: Losing a parent in childhood can significantly impact the child, yet little research examines how cause of parental death may affect children differently. This study aims to investigate risks of deliberate self-harm (DSH) and suicide in bereaved children by parental cause of death.

Method: Data from Norwegian population registers were interlinked to investigate exposure to parental death from specific causes and risks of DSH and suicide via a nested case-control design. Children under the age of 35 who were treated for DSH (n = 20,180) or died by suicide (n = 5039) constituted the cases and were compared with population controls of 20 per case matched by gender and age. Conditional logistic regression models were used to assess the risk.

Results: In the study population, 9.7 % of the DSH cases and 13.1 % of the suicide cases lost a parent. The risk of DSH was increased for bereaved children [OR = 1.54, 95 %CI 1.46-1.62], with the highest risk associated with parental death caused by mental diseases [2.84, 2.34-3.44], followed by accidental poisoning and suicide. The risk of suicide was significantly increased for bereaved children after parental death [1.28, 1.17-1.40], with the highest risk associated with parental death caused by homicide [4.68, 2.18-10.02], followed by suicide and accidental poisoning. No gender interactions or gender-of-deceased interactions was detected.

Conclusion: Parental-bereaved children are at significantly increased risk of DSH and suicide in early life, but the risk differ by parental cause of death. This underscores the importance of psychosocial and familial support for children following a parental loss.

Keywords: Deliberate self-harm; Parental bereavement; Register-based research; Suicide risk; Suicidology.