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Published in: Social Psychiatry and Psychiatric Epidemiology 8/2015

01-08-2015 | Original Paper

Functional impairment due to bereavement after the death of adolescent or young adult offspring in a national population study of 1,051,515 parents

Authors: Holly C. Wilcox, Ellenor Mittendorfer-Rutz, Linnea Kjeldgård, Kristina Alexanderson, Bo Runeson

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 8/2015

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Abstract

Purpose

This study addresses the burden of grief after the death of an adolescent or young adult offspring. Parental bereavement following the death of an adolescent or young adult offspring is associated with considerable psychiatric and somatic impairment. Our aim is to fill a research gap by examining offspring death due to suicide, accidents, or natural causes in relation to risk of parental sickness absence with psychiatric or somatic disorders.

Methods

This whole population-based prospective study included mothers and fathers of all offspring aged 16–24 years in Sweden on December 31, 2004 (n = 1,051,515). This study had no loss to follow-up and exposure, confounders, and the outcome were recorded independently of each other. Cox survival analysis was used to model time to sickness absence exceeding 30 days, adjusting for parental demographic characteristics, previous parental sickness absence and disability pension, and inpatient and outpatient psychiatric and somatic healthcare prior to offspring death in 2001–2004. This large study population provided satisfactory statistical power for stratification by parents’ sex and adolescent and young adults’ cause of death.

Results

Mothers and fathers of offspring suicide and accident decedents both had over tenfold higher risk for psychiatric sickness absence exceeding 30 days as compared to parents of live offspring. Fathers of suicide decedents were at 40 % higher risk for somatic sickness absence.

Conclusions

This is the largest study to date of parents who survived their offspring’s death and the first study of work-related outcomes in bereaved parents. This study uses a broad metric of work-related functional impairment, sickness absence, for capturing the burden of sudden offspring death.
Literature
1.
go back to reference Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) (online) (2014) (cited 2014 November 16). Available from http://www.cdc.gov/ncipc/wisqars Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) (online) (2014) (cited 2014 November 16). Available from http://​www.​cdc.​gov/​ncipc/​wisqars
2.
4.
go back to reference Jordan JR (2001) Is suicide bereavement different? A reassessment of the literature. Suicide Life Threat Behav 31:91–102PubMedCrossRef Jordan JR (2001) Is suicide bereavement different? A reassessment of the literature. Suicide Life Threat Behav 31:91–102PubMedCrossRef
5.
go back to reference Parrish M, Tunkle J (2003) Working with families following their child’s suicide. Fam Ther 30:63–76 Parrish M, Tunkle J (2003) Working with families following their child’s suicide. Fam Ther 30:63–76
6.
go back to reference Pitman A, Osborn D, King M, Erlangsen A (2014) Effects of suicide bereavement on mental health and suicide risk. Lancet Psychiatry 1:86–94CrossRef Pitman A, Osborn D, King M, Erlangsen A (2014) Effects of suicide bereavement on mental health and suicide risk. Lancet Psychiatry 1:86–94CrossRef
7.
go back to reference Reed MD, Greenwald JY (1991) Survivor-victim status, attachment, and sudden death bereavement. Suicide Life Threat Behav 21:385–401PubMed Reed MD, Greenwald JY (1991) Survivor-victim status, attachment, and sudden death bereavement. Suicide Life Threat Behav 21:385–401PubMed
8.
go back to reference Kristensen P, Weisaeth L, Heir T (2012) Bereavement and mental health after sudden and violent losses: a review. Psychiatry 75:76–97PubMedCrossRef Kristensen P, Weisaeth L, Heir T (2012) Bereavement and mental health after sudden and violent losses: a review. Psychiatry 75:76–97PubMedCrossRef
9.
go back to reference Sveen CA, Walby FA (2008) Suicide survivors’ mental health and grief reactions: a systematic review of controlled studies. Suicide Life Threat Behav 38:13–29PubMedCrossRef Sveen CA, Walby FA (2008) Suicide survivors’ mental health and grief reactions: a systematic review of controlled studies. Suicide Life Threat Behav 38:13–29PubMedCrossRef
10.
go back to reference Marmot M, Feeney A, Shipley M, North F, Syme S (1995) Sickness absence as a measure of health status and functioning: from the UK Whitehall II study. J Epidemiol Comm H 49:124–130CrossRef Marmot M, Feeney A, Shipley M, North F, Syme S (1995) Sickness absence as a measure of health status and functioning: from the UK Whitehall II study. J Epidemiol Comm H 49:124–130CrossRef
11.
go back to reference Kivimäki M, Head J, Ferrie EJ, Shipley MJ, Vahtera J, Marmot MG (2003) Sickness absence as a global measure of health: evidence from mortality in the Whitehall II prospective cohort study. BMJ 327:364PubMedCentralPubMedCrossRef Kivimäki M, Head J, Ferrie EJ, Shipley MJ, Vahtera J, Marmot MG (2003) Sickness absence as a global measure of health: evidence from mortality in the Whitehall II prospective cohort study. BMJ 327:364PubMedCentralPubMedCrossRef
12.
go back to reference Kivimäki M, Head J, Ferrie JE, Singh-Manoux A, Westerlund H, Vahtera J, Leclerc A, Melchior M, Chevalier A, Alexanderson K, Zins M, Goldberg M (2008) Sickness absence as a prognostic marker for common chronic conditions: analysis of mortality in the GAZEL study. Occup Environ Med 65:820–826PubMedCentralPubMedCrossRef Kivimäki M, Head J, Ferrie JE, Singh-Manoux A, Westerlund H, Vahtera J, Leclerc A, Melchior M, Chevalier A, Alexanderson K, Zins M, Goldberg M (2008) Sickness absence as a prognostic marker for common chronic conditions: analysis of mortality in the GAZEL study. Occup Environ Med 65:820–826PubMedCentralPubMedCrossRef
13.
go back to reference Hensing G (2004) Methodological aspects in sickness-absence research. Scand J Public Health 32:44–48CrossRef Hensing G (2004) Methodological aspects in sickness-absence research. Scand J Public Health 32:44–48CrossRef
14.
go back to reference StataCorp. (2011) Stata: Release 12. Statistical Software. StataCorp LP, College Station StataCorp. (2011) Stata: Release 12. Statistical Software. StataCorp LP, College Station
15.
go back to reference IBM Corp. (2013) IBM SPSS Statistics for Windows, Version 22.0. IBM Corp, Armonk, New York IBM Corp. (2013) IBM SPSS Statistics for Windows, Version 22.0. IBM Corp, Armonk, New York
16.
go back to reference Bolton JM, Au W, Leslie WD, Martens PJ, Enns MW, Roos LL, Katz LY, Wilcox HC, Erlangsen A, Chateau D, Walld R, Spiwak R, Seguin M, Shear K, Sareen J (2013) Parents bereaved by offspring suicide: a population-based longitudinal case-control study. JAMA Psychiatry 70:158–167PubMedCrossRef Bolton JM, Au W, Leslie WD, Martens PJ, Enns MW, Roos LL, Katz LY, Wilcox HC, Erlangsen A, Chateau D, Walld R, Spiwak R, Seguin M, Shear K, Sareen J (2013) Parents bereaved by offspring suicide: a population-based longitudinal case-control study. JAMA Psychiatry 70:158–167PubMedCrossRef
17.
go back to reference American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn, text rev. American Psychiatric Association, Washington American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn, text rev. American Psychiatric Association, Washington
18.
go back to reference Omerov P, Steineck G, Nyberg T, Runeson B, Nyberg U (2013) Psychological morbidity among suicide-bereaved and non-bereaved parents: a nationwide population survey. BMJ Open 3:e003108PubMedCentralPubMedCrossRef Omerov P, Steineck G, Nyberg T, Runeson B, Nyberg U (2013) Psychological morbidity among suicide-bereaved and non-bereaved parents: a nationwide population survey. BMJ Open 3:e003108PubMedCentralPubMedCrossRef
19.
go back to reference Omerov P, Steineck G, Dyregrov K, Runeson B, Nyberg U (2014) The ethics of doing nothing. Suicide-bereavement and research: ethical and methodological considerations. Psychol Med 44(16):3409–3420PubMedCentralPubMedCrossRef Omerov P, Steineck G, Dyregrov K, Runeson B, Nyberg U (2014) The ethics of doing nothing. Suicide-bereavement and research: ethical and methodological considerations. Psychol Med 44(16):3409–3420PubMedCentralPubMedCrossRef
20.
go back to reference Prigerson HG, Jacobs SC (2001) Perspectives on care at the close of life. Caring for bereaved patients: “all the doctors just suddenly go”. JAMA 286:1369–1376PubMedCrossRef Prigerson HG, Jacobs SC (2001) Perspectives on care at the close of life. Caring for bereaved patients: “all the doctors just suddenly go”. JAMA 286:1369–1376PubMedCrossRef
21.
go back to reference Bolton JM, Au W, Walld R, Chateau D, Martens PJ, Leslie WD, Enns MW, Sareen J (2014) Parental bereavement after the death of an offspring in a motor vehicle collision: a population-based study. Am J Epidemiol 179(2):177–185PubMedCrossRef Bolton JM, Au W, Walld R, Chateau D, Martens PJ, Leslie WD, Enns MW, Sareen J (2014) Parental bereavement after the death of an offspring in a motor vehicle collision: a population-based study. Am J Epidemiol 179(2):177–185PubMedCrossRef
22.
go back to reference Murphy SA, Johnson LC, Wu L, Fan JJ, Lohan J (2003) Bereaved parents’ outcomes 4 to 60 months after their children’s deaths by accident, suicide, or homicide: a comparative study demonstrating differences. Death Stud 27:39–61PubMedCrossRef Murphy SA, Johnson LC, Wu L, Fan JJ, Lohan J (2003) Bereaved parents’ outcomes 4 to 60 months after their children’s deaths by accident, suicide, or homicide: a comparative study demonstrating differences. Death Stud 27:39–61PubMedCrossRef
23.
go back to reference Li J, Laursen TM, Precht DH, Olsen J, Mortensen PB (2005) Hospitalization for mental illness among parents after the death of a child. NEJM 352:1190–1196PubMedCrossRef Li J, Laursen TM, Precht DH, Olsen J, Mortensen PB (2005) Hospitalization for mental illness among parents after the death of a child. NEJM 352:1190–1196PubMedCrossRef
24.
go back to reference Li J, Precht DH, Mortensen PB, Olsen J (2003) Mortality in parents after death of a child in Denmark: a nationwide follow-up study. Lancet 361:363–367PubMedCrossRef Li J, Precht DH, Mortensen PB, Olsen J (2003) Mortality in parents after death of a child in Denmark: a nationwide follow-up study. Lancet 361:363–367PubMedCrossRef
25.
go back to reference Kaslow NJ, Aronson SG (2004) Recommendations for family interventions following a suicide. Prof Psychol Res Pract 35:240–247CrossRef Kaslow NJ, Aronson SG (2004) Recommendations for family interventions following a suicide. Prof Psychol Res Pract 35:240–247CrossRef
26.
go back to reference Barlow CA, Morrison H (2002) Survivors of suicide. Emerging counseling strategies. J Psychosoc Nurs Ment Health Serv 40:28–29PubMed Barlow CA, Morrison H (2002) Survivors of suicide. Emerging counseling strategies. J Psychosoc Nurs Ment Health Serv 40:28–29PubMed
27.
go back to reference Ludvigsson JF, Andersson E, Ekbom A, Feychting M, Kim JL, Reuterwall C, Heurgren M, Olausson PO (2011) External review and validation of the Swedish national inpatient register. BMC Public Health 11:450PubMedCentralPubMedCrossRef Ludvigsson JF, Andersson E, Ekbom A, Feychting M, Kim JL, Reuterwall C, Heurgren M, Olausson PO (2011) External review and validation of the Swedish national inpatient register. BMC Public Health 11:450PubMedCentralPubMedCrossRef
29.
go back to reference Ljungdahl LO, Bjurulf P (1991) The accordance of diagnoses in a computerized sick-leave register with doctor’s certificates and medical records. Scand J Soc Med 19:148–153PubMed Ljungdahl LO, Bjurulf P (1991) The accordance of diagnoses in a computerized sick-leave register with doctor’s certificates and medical records. Scand J Soc Med 19:148–153PubMed
30.
go back to reference Bergström G, Bodin L, Hagberg J, Aronsson G, Josephson M (2009) Sickness presenteeism today, sickness absenteeism tomorrow? A prospective study on sickness presenteeism and future sickness absenteeism. J Occup Environ Med 51(6):629–638PubMedCrossRef Bergström G, Bodin L, Hagberg J, Aronsson G, Josephson M (2009) Sickness presenteeism today, sickness absenteeism tomorrow? A prospective study on sickness presenteeism and future sickness absenteeism. J Occup Environ Med 51(6):629–638PubMedCrossRef
31.
go back to reference Vahtera J, Westerlund H, Ferrie JE, Head J, Melchior M, Singh-Manoux A, Zins M, Goldberg M, Alexanderson K, Kivimäki M (2010) All-cause and diagnosis-specific sickness absence as a predictor of sustained suboptimal health: a 14-year follow-up in the GAZEL cohort. J Epidemiol Community Health 64(4):311–317PubMedCentralPubMedCrossRef Vahtera J, Westerlund H, Ferrie JE, Head J, Melchior M, Singh-Manoux A, Zins M, Goldberg M, Alexanderson K, Kivimäki M (2010) All-cause and diagnosis-specific sickness absence as a predictor of sustained suboptimal health: a 14-year follow-up in the GAZEL cohort. J Epidemiol Community Health 64(4):311–317PubMedCentralPubMedCrossRef
32.
go back to reference Ferrie JE, Kivimäki M, Westerlund H, Head J, Melchior M, Singh-Manoux A, Zins M, Goldberg M, Alexanderson K, Vahtera J (2011) Differences in the association between sickness absence and long-term sub-optimal health by occupational position: a 14-year follow-up in the GAZEL cohort. Occup Environ Med 68(10):729–733PubMedCentralPubMedCrossRef Ferrie JE, Kivimäki M, Westerlund H, Head J, Melchior M, Singh-Manoux A, Zins M, Goldberg M, Alexanderson K, Vahtera J (2011) Differences in the association between sickness absence and long-term sub-optimal health by occupational position: a 14-year follow-up in the GAZEL cohort. Occup Environ Med 68(10):729–733PubMedCentralPubMedCrossRef
33.
go back to reference Poulsen OM, Persson R, Kristiansen J, Andersen LL, Villadsen E, Ørbæk P (2013) Distribution of subjective health complaints, and their association with register based sickness absence in the Danish working population. Scand J Public Health 41(2):150–157PubMedCrossRef Poulsen OM, Persson R, Kristiansen J, Andersen LL, Villadsen E, Ørbæk P (2013) Distribution of subjective health complaints, and their association with register based sickness absence in the Danish working population. Scand J Public Health 41(2):150–157PubMedCrossRef
34.
go back to reference Wijnvoord LE, Van der Klink JJ, De Boer MR, Brouwer S (2014) Predictors of sickness absence in college and university educated self-employed: a historic register study. BMC Public Health 2(14):420CrossRef Wijnvoord LE, Van der Klink JJ, De Boer MR, Brouwer S (2014) Predictors of sickness absence in college and university educated self-employed: a historic register study. BMC Public Health 2(14):420CrossRef
Metadata
Title
Functional impairment due to bereavement after the death of adolescent or young adult offspring in a national population study of 1,051,515 parents
Authors
Holly C. Wilcox
Ellenor Mittendorfer-Rutz
Linnea Kjeldgård
Kristina Alexanderson
Bo Runeson
Publication date
01-08-2015
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 8/2015
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-014-0997-7

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