Journal Article

The association of parental fatal and non-fatal suicidal behaviour with offspring suicidal behaviour and depression: a systematic review and meta-analysis

Gunnell, D., Metcalfe, C., Holmen, T. L., Geulayov, G.

2012

Overview

Children whose parents die by, or attempt, suicide are believed to be at greater risk of suicidal behaviours and affective disorders. We systematically reviewed the literature on these associations and, using meta-analysis, estimated the strength of associations as well as investigated potential effect modifiers (parental and offspring gender, offspring age). We comprehensively searched the literature (Medline, PsycINFO, EMBASE, Web of Science), finding 28 articles that met our inclusion criteria, 14 of which contributed to the meta-analysis. Crude odds ratio and adjusted odds ratio (aOR) were pooled using fixed-effects models. Controlling for relevant confounders, offspring whose parents died by suicide were more likely than offspring of two living parents to die by suicide [aOR 1.94, 95% confidence interval (CI) 1.54-2.45] but there were heterogeneous findings in the two studies investigating the impact on offspring suicide attempt (aOR 1.31, 95% CI 0.73-2.35). Children whose parents attempted suicide were at increased risk of attempted suicide (aOR 1.95, 95% CI 1.48-2.57). Limited evidence indicated that exposure to parental death by suicide is associated with subsequent risk of affective disorders. Maternal suicidal behaviour and younger age at exposure were associated with larger effect estimates but there was no evidence that the association differed in sons versus daughters. Parental suicidal behaviour is associated with increased risk of offspring suicidal behaviour. Findings suggest that maternal suicidal behaviour is a more potent risk factor than paternal, and that children are more vulnerable than adolescents and adults. However, there is no evidence of a stronger association in either male or female offspring.

• Publisher: Cambridge University Press
• Subject: Adolescent / Adolescents / Adult and adolescent clinical studies / Adults / Affective disorders / Age Factors / Associations / Behavior / Biological and medical sciences / Child / Child & adolescent psychiatry / Child of Impaired Parents - psychology / Child of Impaired Parents - statistics & numerical data / Children / Confidence Intervals / Daughters / Depression / Depressive Disorder - epidemiology / Disorders / Emotional disorders / Female / Humans / Literary criticism / Male / Medical sciences / Mental depression / Meta-analysis / Mood disorders / Mothers / Odds Ratio / Parasuicide / Parent-child relations / Parental death / Parental Death - statistics & numerical data / Parents / Parents & parenting / Parents - psychology / Psychology. Psychoanalysis. Psychiatry / Psychopathology. Psychiatry / Risk / Risk Factors / Sex Factors / Suicidal behaviour / Suicide / Suicide - psychology / Suicide - statistics & numerical data / Suicide, Attempted - psychology / Suicide, Attempted - statistics & numerical data / Suicides & suicide attempts / Systematic review