Abstract
BackgroundLosing a child to death is one of the most stressful life events experienced in adulthood. The aim of the current study is to investigate parental risk of seeking treatment for major depression disorders (MDD) after a child’s death and to explore whether such connection may operate differentially by parents’ prior medical condition.MethodsWe studied a retrospective cohort of 7245 parents (2987 mothers and 4258 fathers) identified in the National Health Insurance Research Database of Taiwan (NHIRD) who had lost a child with age between 1 and 12 years. For comparison, the parents of 1:4 birth year- and gender-matched non-deceased children were retrieved (16,512 mothers and 17,753 fathers). Gender-specific Cox regression analyses were performed to estimate risk.ResultsNearly 5.0% and 2.4% of bereaved mothers and fathers sought treatment for MDD within three years after a child’s death, significantly higher than 0.8% and 0.5% in the non-bereaved parents. With covariate adjustment, the hazard ratio (HR) for maternal and paternal seeking treatment for MDD was estimated 4.71 (95% confidence interval [CI]: 3.35–6.64) and 1.93 (95% CI: 1.27–2.95), respectively. The increased risk of MDD varied by prior disease history; specifically, the increased risk of seeking treatment for MDD was especially prominent for those without chronic physical condition (CPC) (e.g., mothers with CPC: aHR = 2.38, 95% CI: 1.56–3.65 vs. no CPC: aHR = 9.55, 95% CI: 6.17–14.79).ConclusionsAfter the death of a child, parental elevated risk of MDD was especially prominent for the women and those without prior medical condition. Effective strategies addressing bereavement may require family-based, integrated physical and mental healthcare and even extended counseling service.
Highlights
Losing a child to death is one of the most stressful life events experienced in adulthood
Cumulative evidence has pointed out several individual-level health and social characteristics associated with increased risk of onset and recurrence of major depression disorders (MDD), including chronic diseases, disadvantaged socioeconomic status, low social integration, and stressful life events [4,5,6,7,8]
Data sources Data for the present study came from the 1998–2013 National Health Institute Research Data (NHIRD), derived from the National Health Insurance Plan (NHIP) in Taiwan
Summary
Losing a child to death is one of the most stressful life events experienced in adulthood. Studies have consistently demonstrated that the bereaved parents may experience greater physiological and psychological disorders, including cancer, diabetes, depression, anxiety, suicidal attempts, and even death through health-compromising behaviors, dysregulated neuroendocrine/immune systems, and intertwined connections with prior vulnerabilities [14,15,16,17]. The emergence of these disorders fluctuates over time and varies by children’s characteristics (e.g., age and unexpectedness of death) [7, 18, 19]. In the case of suicide, the risk was reported to emerge abruptly in the first months of child loss and appeared more salient if the child died in early childhood [20, 21]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
