Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2014

Open Access 01-12-2014 | Research article

Association between parental psychopathology and suicidal behavior among adult offspring: results from the cross-sectional South African Stress and Health survey

Authors: Lukoye Atwoli, Matthew K Nock, David R Williams, Dan J Stein

Published in: BMC Psychiatry | Issue 1/2014

Login to get access

Abstract

Background

Prior studies have demonstrated a link between parental psychopathology and offspring suicidal behavior. However, it remains unclear what aspects of suicidal behavior among adult offspring are predicted by specific parental mental disorders, especially in Africa. This study set out to investigate the association between parental psychopathology and suicidal behavior among their adult offspring in a South African general population sample.

Method

Parental psychopathology and suicidal behavior in offspring were assessed using structured interviews among 4,315 respondents from across South Africa. The WHO CIDI was used to collect data on suicidal behavior, while the Family History Research Diagnostic Criteria Interview was used to assess prior parental psychopathology. Bivariate and multivariate survival models tested the associations between the type and number parental mental disorders (including suicide) and lifetime suicidal behavior in the offspring. Associations between a range of parental disorders and the onset of subsequent suicidal behavior (suicidal ideation, plans, and attempts) among adult offspring were tested.

Results

The presence of parental psychopathology significantly increased the odds of suicidal behavior among their adult offspring. More specifically, parental panic disorder was associated with offspring suicidal ideation, while parental panic disorder, generalized anxiety disorder and suicide were significantly associated with offspring suicide attempts. Among those with suicidal ideation, none of the tested forms of parental psychopathology was associated with having suicide plans or attempts. There was a dose–response relationship between the number of parental disorders and odds of suicidal ideation.

Conclusions

Parental psychopathology increases the odds of suicidal behavior among their adult offspring in the South African context, replicating results found in other regions. Specific parental disorders predicted the onset and persistence of suicidal ideation or attempts in their offspring. Further research into these associations is recommended in order to determine the mechanisms through which parent psychopathology increases the odds of suicidal behavior among offspring.
Literature
1.
2.
World Health Organisation: World Report on Violence on Violence and Health: Summary. 2002, Geneva: World Health Organisation
3.
World Health Organisation: The Global Burden of Disease: 2004 Update. 2008, Geneva: World Health Organisation
4.
Kessler RC, Berglund P, Borges G, Nock M, Wang PS: Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990–1992 to 2001–2003. JAMA. 2005, 293 (20): 2487-2495. 10.1001/jama.293.20.2487.CrossRefPubMed
5.
Kessler RC, Borges G, Walters EE: Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Arch Gen Psychiatry. 1999, 56 (7): 617-626. 10.1001/archpsyc.56.7.617.CrossRefPubMed
6.
Joe S, Stein DJ, Seedat S, Herman A, Williams DR: Non-fatal suicidal behavior among South Africans: results from the South Africa Stress and Health Study. Soc Psychiatry Psychiatr Epidemiol. 2008, 43 (6): 454-461. 10.1007/s00127-008-0348-7.CrossRefPubMedPubMedCentral
7.
Joe S, Stein DJ, Seedat S, Herman A, Williams DR: Prevalence and correlates of non-fatal suicidal behaviour among South Africans. Br J Psychiatry. 2008, 192 (4): 310-311. 10.1192/bjp.bp.107.037697.CrossRefPubMedPubMedCentral
8.
Baldessarini RJ, Hennen J: Genetics of suicide: an overview. Harv Rev Psychiatry. 2004, 12 (1): 1-13.PubMed
9.
Brent DA, Bridge J, Johnson BA, Connolly J: Suicidal behavior runs in families. A controlled family study of adolescent suicide victims. Arch Gen Psychiatry. 1996, 53 (12): 1145-1152. 10.1001/archpsyc.1996.01830120085015.CrossRefPubMed
10.
Brent DA, Mann JJ: Family genetic studies, suicide, and suicidal behavior. Am J Med Genet C Semin Med Genet. 2005, 133 (1): 13-24.CrossRef
11.
Brent DA, Mann JJ: Familial pathways to suicidal behavior–understanding and preventing suicide among adolescents. N Engl J Med. 2006, 355 (26): 2719-2721. 10.1056/NEJMp068195.CrossRefPubMed
12.
13.
Egeland JA, Sussex JN: Suicide and family loading for affective disorders. J Am Med Assoc. 1985, 254 (7): 915-918. 10.1001/jama.1985.03360070053022.CrossRef
14.
Kim CD, Seguin M, Therrien N, Riopel G, Chawky N, Lesage AD, Turecki G: Familial aggregation of suicidal behavior: a family study of male suicide completers from the general population. Am J Psychiatr. 2005, 162 (5): 1017-1019. 10.1176/appi.ajp.162.5.1017.CrossRefPubMed
15.
Mann JJ, Arango VA, Avenevoli S, Brent DA, Champagne FA, Clayton P, Currier D, Dougherty DM, Haghighi F, Hodge SE, Kleinman J, Lehner T, McMahon F, Moscicki EK, Oquendo MA, Pandey GN, Pearson J, Stanley B, Terwilliger J, Wenzel A: Candidate endophenotypes for genetic studies of suicidal behavior. Biol Psychiatry. 2009, 65: 556-563. 10.1016/j.biopsych.2008.11.021.CrossRefPubMedPubMedCentral
16.
Melhem NM, Brent DA, Ziegler M, Iyengar S, Kolko D, Oquendo M, Birmaher B, Burke A, Zelazny J, Stanley B, Mann JJ: Familial pathways to early-onset suicidal behavior: familial and individual antecedents of suicidal behavior. Am J Psychiatr. 2007, 164 (9): 1364-1370. 10.1176/appi.ajp.2007.06091522.CrossRefPubMedPubMedCentral
17.
Wender PH, Kety SS, Rosenthal D, Schulsinger F, Ortmann J, Lunde I: Psychiatric disorders in the biological and adoptive families of adopted individuals with affective disorders. Arch Gen Psychiatry. 1986, 43 (10): 923-929. 10.1001/archpsyc.1986.01800100013003.CrossRefPubMed
18.
Gureje O, Oladeji B, Hwang I, Chiu WT, Kessler RC, Sampson NA, Alonso J, Andrade LH, Beautrais A, Borges G, Bromet E, Bruffaerts R, De Girolamo G, De Graaf R, Gal G, He Y, Hu C, Iwata N, Karam EG, Kovess-Masfety V, Matschinger H, Moldovan MV, Posada-Villa J, Sagar R, Scocco P, Seedat S, Tomov T, Nock MK: Parental psychopathology and the risk of suicidal behavior in their offspring: results from the World Mental Health surveys. Mol Psychiatry. 2010, 16 (12): 1221-1233.CrossRefPubMedPubMedCentral
19.
Qin P, Agerbo E, Mortensen PB: Suicide risk in relation to family history of completed suicide and psychiatric disorders: a nested case–control study based on longitudinal registers. Lancet. 2002, 360 (9340): 1126-1130. 10.1016/S0140-6736(02)11197-4.CrossRefPubMed
20.
Runeson B, Asberg M: Family history of suicide among suicide victims. Am J Psychiatr. 2003, 160 (8): 1525-1526. 10.1176/appi.ajp.160.8.1525.CrossRefPubMed
21.
Sorensen HJ, Mortensen EL, Wang AG, Juel K, Silverton L, Mednick SA: Suicide and mental illness in parents and risk of suicide in offspring: a birth cohort study. Soc Psychiatr Psychiatr Epidemiol. 2009, 44 (9): 748-751. 10.1007/s00127-009-0495-5.CrossRef
22.
Stenager K, Qin P: Individual and parental psychiatric history and risk for suicide among adolescents and young adults in Denmark: a population-based study. Soc Psychiatr Psychiatr Epidemiol. 2008, 43 (11): 920-926. 10.1007/s00127-008-0385-2.CrossRef
23.
Oladeji BD, Gureje O: Parental mental disorders and suicidal behavior in the Nigerian survey of mental health and well-being. Arch Suicide Res. 2011, 15 (4): 372-383. 10.1080/13811118.2011.616151.CrossRefPubMed
24.
Williams DR, Herman A, Kessler RC, Sonnega J, Seedat S, Stein DJ, Moomal H, Wilson CM: The South Africa Stress and Health Study: rationale and design. Metab Brain Dis. 2004, 19 (1–2): 135-147.CrossRefPubMed
25.
Nock MK, Hwang I, Sampson N, Kessler RC: Mental disorders, comorbidity, and suicidal behaviors: results from the National Comorbidity Survey replication. Mol Psychiatry. 2009, 15 (8): 868-876.CrossRefPubMedPubMedCentral
26.
Nock MK, Hwang I, Sampson N, Kessler RC, Angermeyer M, Beautrais A, Borges G, Bromet E, Bruffaerts R, de Girolamo G, De Graaf R, Florescu S, Gureje O, Haro JM, Hu C, Huang Y, Karam EG, Kawakami N, Kovess V, Levinson D, Posada-Villa J, Sagar R, Tomov T, Viana MC, Williams DR: Cross-national analysis of the associations among mental disorders and suicidal behavior: findings from the WHO world mental health surveys. PLoS Med. 2009, 6: e1000123-10.1371/journal.pmed.1000123.CrossRefPubMedPubMedCentral
27.
Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine JP, Angermeyer MC, Bernert S, de Girolamo G, Morosini P, Polidori G, Kikkawa T, Kawakami N, Ono Y, Takeshima T, Uda H, Karam EG, Fayyad JA, Karam AN, Mneimneh ZN, Medina-Mora ME, Borges G, Lara C, de Graaf R, Ormel J, Gureje O, Shen Y, Huang Y, Zhang M, Alonso J, et al: Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA. 2004, 291 (21): 2581-2590.CrossRefPubMed
28.
Williams DR, Herman A, Stein DJ, Heeringa SG, Jackson PB, Moomal H, Kessler RC: Twelve-month mental disorders in South Africa: prevalence, service use and demographic correlates in the population-based South African Stress and Health Study. Psychol Med. 2008, 38 (2): 211-220.CrossRefPubMed
29.
Kessler RC, Ustun TB: The World Mental Health (WMH) survey initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res. 2004, 13 (2): 93-121. 10.1002/mpr.168.CrossRefPubMed
30.
Andrews G, Peters L: The psychometric properties of the Composite International Diagnostic Interview. Soc Psychiatry Psychiatr Epidemiol. 1998, 33 (2): 80-88. 10.1007/s001270050026.CrossRefPubMed
31.
Haro JM, Arbabzadeh-Bouchez S, Brugha TS, de Girolamo G, Guyer ME, Jin R, Lepine JP, Mazzi F, Reneses B, Vilagut G, Sampson NA, Kessler RC: Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health surveys. Int J Methods Psychiatr Res. 2006, 15 (4): 167-180. 10.1002/mpr.196.CrossRefPubMed
32.
Andreasen NC, Endicott J, Spitzer RL, Winokur G: The family history method using diagnostic criteria. Reliability and validity. Arch Gen Psychiatry. 1977, 34 (10): 1229-1235. 10.1001/archpsyc.1977.01770220111013.CrossRefPubMed
33.
Kendler KS, Davis CG, Kessler RC: The familial aggregation of common psychiatric and substance use disorders in the National Comorbidity Survey: a family history study. Br J Psychiatry. 1997, 170: 541-548. 10.1192/bjp.170.6.541.CrossRefPubMed
34.
Efron B: Logistic regression, survival analysis, and the Kaplan Meier curve. J Am Stat Assoc. 1988, 83: 414-425. 10.1080/01621459.1988.10478612.CrossRef
35.
Wolter KM: Introduction to Variance Estimation. 1985, New York, NY: Springer-Verlag
36.
SUDAAN 9.0.2: Professional Software for Survey Data Analysis [computer program]. 2005, Research Triangle Park, NC: Research Triangle Institute
37.
Williams SL, Williams DR, Stein DJ, Seedat S, Jackson PB, Moomal H: Multiple traumatic events and psychological distress: the South Africa stress and health study. J Trauma Stress. 2007, 20 (5): 845-855. 10.1002/jts.20252.CrossRefPubMedPubMedCentral
38.
Angst J, Sellaro R, Ries Merikangas K: Multimorbidity of psychiatric disorders as an indicator of clinical severity. Eur Arch Psychiatry Clin Neurosci. 2002, 252 (4): 147-154. 10.1007/s00406-002-0357-6.CrossRefPubMed
39.
Hawton K, Houston K, Haw C, Townsend E, Harriss L: Comorbidity of Axis I and Axis II disorders in patients who attempted suicide. Am J Psychiatry. 2003, 160 (8): 1494-1500. 10.1176/appi.ajp.160.8.1494.CrossRefPubMed
40.
Beardslee WR, Versage EM, Gladstone TRG: Children of affectively ill parents: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 1998, 37: 1134-1141. 10.1097/00004583-199811000-00012.CrossRefPubMed
41.
Vostanis P, Graves A, Meltzer H, Goodman R, Jenkins R, Brugha TS: Relationship between parental psychopathology, parenting strategies and child mental health– findings from the GB national study. Soc Psychiatry Psychiatr Epidemiol. 2006, 41: 509-514. 10.1007/s00127-006-0061-3.CrossRefPubMed
42.
Caspi A, Sugden K, Moffitt TE, Taylor A, Craig IW, Harrington H, McClay J, Mill J, Martin J, Braithwaite A, Poulton R: Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science. 2003, 301 (5631): 386-389. 10.1126/science.1083968.CrossRefPubMed
43.
Moffitt TE: The new look of behavioral genetics in developmental psychopathology: gene-environment interplay in antisocial behaviors. Psychol Bull. 2005, 131 (4): 533-554.CrossRefPubMed
44.
Weissman MM, Klerman GL, Markowitz JS, Ouellette R: Suicidal ideation and suicide attempts in panic disorder and attacks. N Engl J Med. 1989, 321 (18): 1209-1214. 10.1056/NEJM198911023211801.CrossRefPubMed
45.
Kuramoto SJ, Stuart EA, Runeson B, Lichtenstein P, Langstrom N, Wilcox HC: Maternal or paternal suicide and offspring’s psychiatric and suicide-attempt hospitalization risk. Pediatrics. 2010, 126 (5): e1026-e1032. 10.1542/peds.2010-0974.CrossRefPubMedPubMedCentral
46.
Geulayov G, Gunnell D, Holmen TL, Metcalfe C: The association of parental fatal and non-fatal suicidal behaviour with offspring suicidal behaviour and depression: a systematic review and meta-analysis. Psychol Med. 2012, 42 (8): 1567-1580. 10.1017/S0033291711002753.CrossRefPubMed
47.
Jeon HJ, Hong JP, Fava M, Mischoulon D, Nyer M, Inamori A, Sohn JH, Seong S, Cho MJ: Childhood parental death and lifetime suicide attempt of the opposite-gender offspring in a nationwide community sample of Korea. Suicide Life Threat Behav. 2013, 43 (6): 598-610. 10.1111/sltb.12042.CrossRefPubMed
48.
Angold A, Erkanli A, Costello EJ, Rutter M: Precision, reliability and accuracy in the dating of symptom onsets in child and adolescent psychopathology. J Child Psychol Psychiatry. 1996, 37 (6): 657-664. 10.1111/j.1469-7610.1996.tb01457.x.CrossRefPubMed
49.
Hardt J, Rutter M: Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatry. 2004, 45 (2): 260-273. 10.1111/j.1469-7610.2004.00218.x.CrossRefPubMed
Metadata
Title
Association between parental psychopathology and suicidal behavior among adult offspring: results from the cross-sectional South African Stress and Health survey
Authors
Lukoye Atwoli
Matthew K Nock
David R Williams
Dan J Stein
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2014
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-14-65

Other articles of this Issue 1/2014

BMC Psychiatry 1/2014 Go to the issue

Research article

Pharmacotherapy for acute mania and disconcordance with treatment guidelines: bipolar mania pathway survey (BIPAS) in mainland China

Study protocol

A familial risk enriched cohort as a platform for testing early interventions to prevent severe mental illness

Research article

Clinical and sociodemographic correlates of suicidality in patients with major depressive disorder from six Asian countries

Research article

Disorder-specific cognitive profiles in major depressive disorder and generalized anxiety disorder

Study protocol

Implementation of an intensive short-term dynamic treatment program for patients with treatment-resistant disorders in residential care

Research article

Saving time and money: a validation of the self ratings on the prospective NIMH life-chart method (NIMH-LCM)