Hospitalization for Mental Illness among Parents after the Death of a Child

Department of Epidemiology and Social Medicine, Aarhus University, Aarhus, Central Jutland, Denmark
New England Journal of Medicine (Impact Factor: 55.87). 04/2005; 352(12):1190-6. DOI: 10.1056/NEJMoa033160
Source: PubMed


The loss of a child is considered one of the most stressful events in the life of a parent. We hypothesized that parental bereavement increases the risk of hospital admission for a psychiatric disorder, especially for affective disorders.
We studied a cohort of 1,082,503 persons identified from national registers in Denmark who were born between 1952 and 1999 and had at least one child under 18 years of age during the follow-up period, from 1970 to 1999. Parents who lost a child during follow-up were categorized as "bereaved" from the date of death of the child.
As compared with parents who did not lose a child, parents who lost a child had an overall relative risk of a first psychiatric hospitalization for any disorder of 1.67 (95 percent confidence interval, 1.53 to 1.83). Bereaved mothers had a higher relative risk of being hospitalized for any psychiatric disorder than bereaved fathers (relative risks, 1.78 [95 percent confidence interval, 1.60 to 1.98] and 1.38 [95 percent confidence interval, 1.17 to 1.63], respectively; P value for interaction, 0.01). The relative risks of hospitalization specifically for affective disorders were 1.91 (95 percent confidence interval, 1.59 to 2.30) and 1.61 (95 percent confidence interval, 1.15 to 2.27) for bereaved mothers and fathers, respectively. Among mothers, the relative risk of being hospitalized for any psychiatric disorder was highest during the first year after the death of the child but remained significantly elevated five years or more after the death.
The risk of psychiatric hospitalization was increased among parents, especially mothers, who lost a child.

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    • "For example, many parents experience a child's death as an unnatural violation of the life cycle, representing the loss of connection to the future and unfulfilled dreams and plans [5] [6]. The grief that follows may never go away, causing physical, emotional, and mental health consequences that can be debilitating for months or years [6] [7] [8] [9]. Sequelae of bereavement include increased risk of morbidity and mortality [10] [11] [12] [13]. "
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    ABSTRACT: Grief following child loss is profoundly destabilizing with serious long-term repercussions for bereaved parents. Employed parents may need time away from work to deal with this loss.OBJECTIVE: The purpose of this study was to reflect upon the ways labour policies and practices respond to parental bereavement.METHODS: Critical discourse analysis was used to examine labour policies and practices related to employment leave for bereaved parents in Canada. Results were compared to international labour standards.RESULTS: Universally, employment policies provide only for the practical issues of bereavement. Commonly, leave is three days, unpaid, and meant to enable ceremonial obligations. Policies do not acknowledge the long-term suffering caused by grief or the variable intensity of different kinds of loss. Managerial, moral, normative and neoliberal values embedded in these policies efface the intensely personal experience of grief, thereby leaving employees at risk for serious health and workplace safety issues.CONCLUSIONS: Bereavement leave currently understands grief as a generic, time-limited state with instrumental tasks and ceremonial obligations. In contrast, research characterizes responses to child loss as intense, highly personal experiences for which healing and recovery can take years. This disconnect is especially problematic when viewed through the lens of employee wellbeing, reintegration and workplace productivity.
    Full-text · Article · Sep 2014 · Work
    • "oista (Arnold & Gemma 2008) ja yksilöllistä (Laakso & Paunonen-Ilmonen 2001, Aho 2010). Vaikka ajan kuluminen lapsen kuolemasta auttaa vanhempia selviytymään (McCarthy ym. 2010, Parker & Dunn 2011), lapsen kuolema voi vaikuttaa kielteisesti vanhempien elämään vielä vuosienkin jälkeen (Azaiza ym. 2011) lisäten fyysistä ja psyykkistä sairastavuutta (Li ym. 2005, Stroebe ym. 2007) sekä kuoleman toivetta ja itsemurha-ajatuksia (Stroebe ym. 2007, Harper ym. 2011). Lapsen kuolema vaikuttaa myös vanhempien sosiaalisiin suhteisiin ja identiteettiin (Aho 2010, Koskela 2011). Vanhempien ja koko perheen elämän kannalta on tärkeää tietää keinoja, joiden avulla vanhempien selviytymistä voidaan edistää ja"
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    ABSTRACT: Tutkimuksen tarkoituksena oli kuvata vanhempien selviytymistä auttavia tekijöitä lapsen kuoleman jälkeen. Tutkimuksen tiedonantajina olivat äidit (n = 143) ja isät (n = 102), joilta oli kuollut kolmivuotias tai sitä nuorempi lapsi, mukaan lukien kohtukuolemat. Aineisto kerättiin kuusi kuukautta lapsen kuoleman jälkeen kyselylomakkeella, joka sisälsi taustamuuttujia ja avokysymyksen. Aineisto analysoitiin induktiivista sisällönanalyysia käyttäen. Vanhempien selviytymisessä lapsen kuoleman jälkeen auttoi kuoleman kohtaaminen, johon sisältyi lapsen kuolemaan valmistautuminen sekä lapsen elämän ja kuoleman kokeminen hyvänä. Toiseksi tuen saaminen ja antaminen, johon sisältyi tiedon saaminen, hoitoon ja käytäntöihin liittyvä tuen saaminen, surussa tuen saaminen, perheen kanssa yhdessä sureminen sekä samankokeneiden surun ja selviytymisen jakaminen. Kolmanneksi sureminen, johon liittyi tilanteen käsitteleminen ja hyväksyminen, arjen eläminen sekä välttäminen. Lisäksi vanhempien selviytymistä auttoi aikaisemmat kokemukset ja usko tulevaisuuteen, johon sisältyi omien voimavarojen hyödyntäminen, vanhemmuuden säilyminen ja tulevaisuuteen suuntautuminen sekä korkeampaan voimaan uskominen, johon liittyi hengellisyys ja kuoleman merkityksellisyyden kokeminen. The purpose of the study was to describe factors that help parents’ coping with child’s death. The informants of the study were mothers (n = 143) and fathers (n = 102), whose child had died at the age of three or under, including stillbirth. The data were collected six months after the child’s death with a questionnaire, including background variables and one open ended question. The data were analysed using inductive content analysis. The factors that help the coping of parents with a child’s death were facing the death that included preparing to the death and experiencing the child’s life and death having been good. Secondly, receiving and giving support that included getting information, getting support related to care and practical issues, getting support at grieving, grieving together with the family, sharing the grief and the coping of the peers. Thirdly grieving that included dealing and accepting the situation, living everyday life and avoiding. In addition, previous experiences and faith to the future that included utilization of own resources, keeping the parenthood and focusing to the future and also believing to the higher power that included spirituality and experiencing the importance of the death, helped the coping of parents.
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    • "The trauma of losing a family member to suicide poses risk that survivors will experience complicated grief and long-term psychological morbidity (Kessing et al. 2003; Li et al. 2005; Groot et al. 2006). Adequate professional intervention might reduce this risk, but the development of evidence-based practice has been delayed by the lack of evidence-based knowledge. "
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    ABSTRACT: Valuable trauma-related research may be hindered when the risks of asking participants about traumatic events are not carefully weighed against the benefits of their participation in the research. Method The overall aim of our population-based survey was to improve the professional care of suicide-bereaved parents by identifying aspects of care that would be amenable to change. The study population included 666 suicide-bereaved and 377 matched (2:1) non-bereaved parents. In this article we describe the parents' perceptions of their contacts with us as well as their participation in the survey. We also present our ethical-protocol for epidemiological surveys in the aftermath of a traumatic loss. We were able to contact 1410 of the 1423 eligible parents; eight of these parents expressed resentment towards the contact. Several participants and non-participants described their psychological suffering and received help because of the contact. A total of 666 suicide-bereaved and 377 non-bereaved parents returned the questionnaire. Just two out of the 1043 answered that they might, in the long term, be negatively affected by participation in the study; one was bereaved, the other was not. A significant minority of the parents reported being temporarily negatively affected at the end of their participation, most of them referring to feelings of sadness and painful memories. In parallel, positive experiences were widely expressed and most parents found the study valuable. Our findings suggest, given that the study design is ethically sound, that suicide-bereaved parents should be included in research since the benefits clearly outweigh the risks.
    Full-text · Article · Jul 2013 · Psychological Medicine
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