Early Parental Death and Risk of Psychosis in Offspring: A Six-Country Case-Control Study.

Supriya Misra,Bizu Gelaye,Craig Morgan,Daniele La Barbera,Manuel Arrojo,Miguel Bernardo,Cristina Marta Del-Ben,Robin M Murray,Caterina La Cascia,Lieuwe De Haan,Celso Arango,Julio Sanjuán,Marta Di Forti,Diego Quattrone,Christina P.C Borba,Domenico Berardi,Julio Bobes,Eva Velthorst,Paulo Rossi Menezes,Andrea Tortelli,Karestan C Koenen,Ilaria Tarricone,Jim Van Os,David R Williams,Peter M Jones ,José Luís Santos ,Jean‐Paul Selten ,Bart P F Rutten ,Andreı̈ Szöke ,Charlotte Gayer‐Anderson ,James Kirkbride

doi:10.3390/jcm8071081

Abstract

Evidence for early parental death as a risk factor for psychosis in offspring is inconclusive. We analyzed data from a six-country, case-control study to examine the associations of early parental death, type of death (maternal, paternal, both), and child’s age at death with psychosis, both overall and by ethnic group. In fully adjusted multivariable mixed-effects logistic regression models, experiencing early parental death was associated with 1.54-fold greater odds of psychosis (95% confidence interval (CI): 1.23, 1.92). Experiencing maternal death had 2.27-fold greater odds (95% CI: 1.18, 4.37), paternal death had 1.14-fold greater odds (95% CI: 0.79, 1.64), and both deaths had 4.42-fold greater odds (95% CI: 2.57, 7.60) of psychosis compared with no early parental death. Experiencing parental death between 11 and 16 years of age had 2.03-fold greater odds of psychosis than experiencing it before five years of age (95% CI: 1.02, 4.04). In stratified analyses, experiencing the death of both parents had 9.22-fold greater odds of psychosis among minority ethnic groups (95% CI: 2.02–28.02) and no elevated odds among the ethnic majority (odds ratio (OR): 0.96; 95% CI: 0.10–8.97), which could be due in part to the higher prevalence of early parental death among minority ethnic groups but should be interpreted cautiously given the wide confidence intervals.

Highlights

Parental death, when a child experiences the loss of a parent before age 18, is one of the most severe and distressing stressors a person can experience and a potential risk factor for adult psychopathology
Our study found that some minority ethnic groups had a higher prevalence of early parental death—especially the death of both parents—compared with the ethnic majority
Considering the structural antecedents to early parental death will be an important avenue for future research. These results add to the emerging evidence that there is an association between early parental death and odds of psychosis in offspring and that this association varies by the type of death

Summary

Introduction

Parental death, when a child experiences the loss of a parent before age 18, is one of the most severe and distressing stressors a person can experience and a potential risk factor for adult psychopathology. A recent population-based case-control study from the United Kingdom found a similar association (odds ratio (OR): 1.80, 95% CI: 0.87–3.73) [3], and six of seven studies using Nordic national register data found similar associations (ORs 1.2–1.3; incidence rate ratios (IRRs) 1.2–2.0) between early loss and an increased risk of psychosis. Though some of these studies relied on the same registers, each used different definitions of early loss, making comparison difficult [4,5,6,7,8,9,10]

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