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 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

Physical and psychosomatic health outcomes in people bereaved by suicide compared to people bereaved by other modes of death: a systematic review

Authors: Ailbhe Spillane, Celine Larkin, Paul Corcoran, Karen Matvienko-Sikar, Fiona Riordan, Ella Arensman

Published in: BMC Public Health | Issue 1/2017

Login to get access

Abstract

Background

Little research has been conducted into the physical health implications of suicide bereavement compared to other causes of death. There is some evidence that suicide bereaved parents have higher morbidity, particularly in terms of chronic illness. This systematic review aims to examine the physical and psychosomatic morbidities of people bereaved by a family member’s suicide and compare them with family members bereaved by other modes of death.

Methods

MEDLINE, EMBASE, CINAHL, and PsycINFO were searched from 1985 to February 2016. The search was re-run in March 2017. Peer-reviewed English language articles comparing suicide-bereaved family members to non-suicide bereaved family members on measures of physical or psychosomatic health were eligible for inclusion. Cohort, cross-sectional, case-control and cohort-based register studies were eligible for inclusion. A modified version of the Newcastle Ottawa Scale was used for quality assessment. Results were synthesised using narrative synthesis.

Results

The literature search located 24 studies which met the inclusion criteria. Seven studies found statistically significant associations between physical health and suicide bereavement. Five of the studies found that suicide-bereaved family members were more likely to experience pain, more physical illnesses and poorer general health. They were also at increased risk of cardiovascular disease, hypertension, diabetes and chronic obstructive pulmonary disease. In contrast, another study in Denmark found that those bereaved by suicide had a lower risk of a number of physical health disorders, including cancers, diabetes, cardiovascular and chronic lower respiratory tract disorders compared to those bereaved by other causes of death. Additionally, a further study conducted in the United States found that suicide-bereaved children visited a GP less frequently than non-suicide bereaved children.

Conclusions

Review findings are relevant for clinicians working with people bereaved by suicide as they highlight that such clients are at increased risk of several adverse physical health outcomes. Future research should examine health risk behaviours of suicide-bereaved and non-suicide bereaved family members as they may confound the association between exposure and outcome.

Trial Registrations

The review protocol has been registered on PROSPERO, registration number CRD42016030007.
Appendix
Available only for authorised users
Literature
1.
Shear MK, Simon N, Wall M, Zisook S, Neimeyer R, Duan N, Reynolds C, Lebowitz B, Sung S, Ghesquiere A, et al. Complicated grief and related bereavement issues for DSM-5. Depress Anxiety. 2011;28(2):103–17.CrossRefPubMedPubMedCentral
2.
3.
World Health Organisation. Preventing suicide: a global imperative. Luxembourg: World Health Organisation; 2014. p. 89.
4.
Pitman A, Osborn D, King M, Erlangsen A. Effects of suicide bereavement on mental health and suicide risk. Lancet Psychiatry. 2014;1(1):86–94.CrossRefPubMed
5.
Shepard DS, Gurewich D, Lwin AK, Reed GA Jr, Silverman MM. Suicide and suicidal attempts in the United States: costs and policy implications. Suicide Life Threat Behav. 2016;46(3):352–62.CrossRefPubMed
6.
Etzersdorfer E, Klein J, Baus N, Sonneck G, Kapusta ND. Epidemiology of suicide in Austria during 2000-2010: potential years of life lost: time for the national suicide prevention program. Wien Klin Wochenschr. 2015;127(7–8):308–13.CrossRefPubMed
7.
8.
Lukaschek K, Erazo N, Baumert J, Ladwig K-H. Suicide mortality in comparison to traffic accidents and homicides as causes of unnatural death. An analysis of 14,441 cases in Germany in the year 2010. Int J Environ Res Public Health. 2012;9(3):924–31.CrossRefPubMedPubMedCentral
9.
McIntosh JL. Control group studies of suicide survivors: a review and critique. Suicide Life Threat Behav. 1993;23(2):146–61.PubMed
10.
Jordan JR. Is suicide bereavement different? A reassessment of the literature. Suicide Life Threat Behav. 2001;31(1):91–102.CrossRefPubMed
11.
Pitman AL, Osborn DPJ, Rantell K, King MB. Bereavement by suicide as a risk factor for suicide attempt: a cross-sectional national UK-wide study of 3432 young bereaved adults. BMJ Open. 2016;6(1):1-12.
12.
Brent DA, Melhem NM, Oquendo M, Burke A, Birmaher B, Stanley B, Biernesser C, Keilp J, Kolko D, Ellis S. Familial pathways to early-onset suicide attempt a 5.6-year prospective study. JAMA Psychiatry. 2015;72(2):160–8.CrossRefPubMedPubMedCentral
13.
14.
Sveen C-A, Walby FA. Suicide survivors’ mental health and grief reactions: a systematic review of controlled studies. Suicide Life Threat Behav. 2008;38(1):13–29.CrossRefPubMed
15.
Cvinar JG. Do suicide survivors suffer social stigma: a review of the literature. Perspect Psychiatr Care. 2005;41(1):14–21.CrossRefPubMed
16.
Brent D, Melhem N, Donohoe MB, Walker M. The incidence and course of depression in bereaved youth 21 months after the loss of a parent to suicide, accident, or sudden natural death. Am J Psychiatry. 2009;166(7):786–94.CrossRefPubMedPubMedCentral
17.
Currier JM, Holland JM, Neimeyer RA. Sense-making, grief, and the experience of violent loss: toward a mediational model. Death Stud. 2006;30(5):403–28.CrossRefPubMed
18.
Mitchell AM, Kim Y, Prigerson HG, Mortimer-Stephens M. Complicated grief in survivors of suicide. Crisis. 2004;25(1):12.CrossRefPubMed
19.
Bolton JM, Au W, Leslie WD, Martens PJ, Enns MW, Roos LL, Katz LY, Wilcox HC, Erlangsen A, Chateau D, et al. Parents bereaved by offspring suicide: a population-based longitudinal case-control study. JAMA Psychiatry. 2013;70(2):158–67.CrossRefPubMed
20.
Huang J, Valdimarsdottir U, Fall K, Ye W, Fang F. Pancreatic cancer risk after loss of a child: a register-based study in Sweden during 1991-2009. Am J Epidemiol. 2013;178(4):582–9.CrossRefPubMed
21.
Farberow NL, Gallagher DE, Gilewski MJ, Thompson LW. An examination of the early impact of bereavement on psychological distress in survivors of suicide. The Gerontologist. 1987;27(5):592–8.CrossRefPubMed
22.
Farberow NL, Gallagher-Thompson D, Gilewski M, Thompson L. Changes in grief and mental health of bereaved spouses of older suicides. J Gerontol. 1992;47(6):P357–66.CrossRefPubMed
23.
Xu G, Li N. A comparison study on mental health status between suicide survivors and survivors of accidental deaths in rural China. J Psychiatr Ment Health Nurs. 2014;21(10):859–65.CrossRefPubMed
24.
Pfeffer CR, Karus D, Siegel K, Jiang H. Child survivors of parental death from cancer or suicide: depressive and behavioral outcomes. Psycho-Oncology. 2000;9(1):1–10.CrossRefPubMed
25.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9. w264CrossRefPubMed
26.
Momen NC, Olsen J, Gissler M, Cnattingius S, Li J. Early life bereavement and childhood cancer: a nationwide follow-up study in two countries. BMJ Open. 2013;3(5):1-8.
27.
Perera S, Eisen RB, Dennis BB, Bawor M, Bhatt M, Bhatnagar N, Thabane L, de Souza R, Samaan Z. Body Mass Index Is an Important Predictor for Suicide: Results from a Systematic Review and Meta-Analysis. Suicide Life Threat Behav. 2016:n/a-n/a.
28.
Grad OT, Zavasnik A. Similarities and differences in the process of bereavement after suicide and after traffic fatalities in Slovenia. OMEGA. 1996;33(3):243–51.
29.
Gilewski MJ, Farberow NL, Gallagher DE, Thompson LW. Interaction of depression and bereavement on mental health in the elderly. Psychol Aging. 1991;6(1):67–75.CrossRefPubMed
30.
de Groot MH, de Keijser J, Neeleman J. Grief shortly after suicide and natural death: a comparative study among spouses and first-degree relatives. Suicide Life Threat Behav. 2006;36(4):418–31.CrossRef
31.
Séguin M, Lesage A, Kiely MC. Parental bereavement after suicide and accident: a comparative study. Suicide Life Threat Behav. 1995;25(4):489–98.PubMed
32.
Miyabayashi S, Yasuda J. Effects of loss from suicide, accidents, acute illness and chronic illness on bereaved spouses and parents in Japan: their general health, depressive mood, and grief reaction. Psychiatry Clin Neurosci. 2007;61(5):502–8.CrossRefPubMed
33.
Dyregrov K, Nordanger D, Dyregrov A. Predictors of psychosocial distress after suicide, SIDS and accidents. Death Stud. 2003;27(2):143–65.CrossRefPubMed
34.
Cerel J, Fristad MA, Weller EB, Weller RA. Suicide-bereaved children and adolescents: a controlled longitudinal examination. J Am Acad Child Adolesc Psychiatry. 1999;38(6):672-9. doi:10.​1097/​00004583-199906000-00013. [published Online First: Epub Date].
35.
Erlangsen A, Runeson B, Bolton JM, et al. Association between spousal suicide and mental, physical, and social health outcomes: a longitudinal and nationwide register-based study. JAMA Psychiatry. 2017;74:456-64.
36.
Barrett TW, Scott TB. Suicide bereavement and recovery patterns compared with nonsuicide bereavement patterns. Suicide Life Threat Behav. 1990;20(1):1–15.PubMed
37.
Cleiren MPHD, Diekstra RFW, Kerkhof AJFM, van der Wal J. Mode of death and kinship in bereavement: focusing on ‘who’ rather than ‘how’. Crisis. 1994;15(1):22–36.PubMed
38.
Demi AS, Miles MS. Suicide bereaved parents: emotional distress and physical health problems. Death Stud. 1988;12(4):297–307.CrossRef
39.
Grad O, Zavasnik A. Phenomenology of bereavement process after suicide, traffic accident and terminal illness (in spouses). Arch Suicide Res. 1999;5(2):157–72.
40.
Harwood D, Hawton K, Hope T, Jacoby R. The grief experiences and needs of bereaved relatives and friends of older people dying through suicide: a descriptive and case-control study. J Affect Disord. 2002;72(2):185–94.CrossRefPubMed
41.
Kitson GC. Adjustment to violent and natural deaths in later and earlier life for black and white widows. J Gerontol Ser B Psychol Sci Soc Sci. 2000;55(6):S341–51.CrossRef
42.
McNiel DE, Hatcher C, Reubin R. Family survivors of suicide and accidental death: consequences for widows. Suicide Life Threat Behav. 1988;18(2):137–48.CrossRefPubMed
43.
Reed MD, Greenwald JY. Survivor-victim status, attachment, and sudden death bereavement. Suicide Life Threat Behav. 1991;21(4):385–401.PubMed
44.
Fang F, Fall K, Sparen P, Adami HO, Valdimarsdottir HB, Lambe M, Valdimarsdottir U. Risk of infection-related cancers after the loss of a child: a follow-up study in Sweden. Cancer Res. 2011;71(1):116–22.CrossRefPubMed
45.
Kennedy B, Valdimarsdottir U, Sundstrom K, Sparen P, Lambe M, Fall K, Fang F. Loss of a parent and the risk of cancer in early life: a nationwide cohort study. Cancer Causes Control. 2014;25(4):499–506.CrossRefPubMed
46.
Weinberg RJ, Dietz LJ, Stoyak S, Melhem NM, Porta G, Payne MW, Brent DA. A prospective study of parentally bereaved youth, caregiver depression, and body mass index. J Clin Psychiatry. 2013;74(8):834–40.CrossRefPubMedPubMedCentral
47.
Wilcox HC, Mittendorfer-Rutz E, Kjeldgard L, Alexanderson K, Runeson B. Functional impairment due to bereavement after the death of adolescent or young adult offspring in a national population study of 1,051,515 parents. Soc Psychiatry Psychiatr Epidemiol. 2015;50(8):1249–56.CrossRefPubMed
48.
49.
Brown AC, Sandler IN, Tein JY, Liu X, Haine RA. Implications of parental suicide and violent death for promotion of resilience of parentally-bereaved children. Death Stud. 2007;31(4):301–35.CrossRefPubMed
50.
Pitman AL, Osborn DP, Rantell K, King MB. The stigma perceived by people bereaved by suicide and other sudden deaths: a cross-sectional UK study of 3432 bereaved adults. J Psychosom Res. 2016;87:22–9.CrossRefPubMedPubMedCentral
51.
Hanschmidt F, Lehnig F, Riedel-Heller SG, Kersting A. The stigma of suicide survivorship and related consequences-a systematic review. PLoS One. 2016;11(9):e0162688.CrossRefPubMedPubMedCentral
52.
Shields C, Kavanagh M, Russo K. A qualitative systematic review of the bereavement process following suicide. Omega. 2017;74(4):426–54.PubMed
53.
Lichtenthal WG, Neimeyer RA, Currier JM, Roberts K, Jordan N. Cause of death and the quest for meaning after the loss of a child. Death Stud. 2013;37(4):311–42.CrossRefPubMedPubMedCentral
54.
Feigelman W, Jordan JR, Gorman BS. Parental grief after a child’s drug death compared to other death causes: investigating a greatly neglected bereavement population. Omega. 2011;63(4):291–316.PubMed
Metadata
Title
Physical and psychosomatic health outcomes in people bereaved by suicide compared to people bereaved by other modes of death: a systematic review
Authors
Ailbhe Spillane
Celine Larkin
Paul Corcoran
Karen Matvienko-Sikar
Fiona Riordan
Ella Arensman
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4930-3

Other articles of this Issue 1/2017

BMC Public Health 1/2017 Go to the issue

Research article

Epidemiology of pertussis in Alberta, Canada 2004–2015

Research article

A study on the influence of internet addiction and online interpersonal influences on health-related quality of life in young Vietnamese

Correction

Correction to: The indirect and direct pathways between physical fitness and academic achievement on commencement in post-compulsory education in a historical cohort of Danish school youth

Research article

“I would rather be told than not know” - A qualitative study exploring parental views on identifying the future risk of childhood overweight and obesity during infancy

Research article

Reduced egfr, elevated urine protein and low level of personal protective equipment compliance among artisanal small scale gold miners at Bibiani-Ghana: a cross-sectional study

Research article

The economic burden of adult asthma in Cyprus; a prevalence-based cost of illness study