Abstract
Parental separation is a very common childhood adversity. The association between other adverse childhood experiences and an increased risk of psychosis has been reported. However, the evidence on the risk of psychosis for children of separated parents is limited. In this systematic review, cohort, case-control, and cross-sectional studies, comparing the risk of psychotic disorders for people with and without separated parents, were searched, critically appraised, and summarized. Studies were searched in PubMed, EMBASE, PsycINFO, and the Web of Science, from database inception to September 2019. A meta-analysis, using random-effects models, was undertaken to obtain pooled estimates of the risk of psychosis among participants with separated parents. Twelve studies, with 305,652 participants from 22 countries, were included in the review. A significantly increased risk of psychosis for those with separated parents was observed, with a pooled odds ratio: 1.53 (95% confidence interval [CI]: 1.29-1.76), p<0.001. The association remained significant when cohort, case-control, and cross-sectional studies were analyzed separately. The five cohort studies included in this review showed and increased risk of psychosis with odds ratio: 1.47 (95% CI: 1.26-1.69), p<0.001. Parental separation is a common childhood adversity associated with an increased risk of psychosis. Although the risk for an individual child of separated parents is still low, given the high proportion of couple that separate, the increased rates of psychosis may be substantial in the population. Further studies on the risk of psychosis in those with separated parents, and the explanatory factors for this association, are required.
Highlights
The dissolution of marriage is common, affecting 46% of married couples in the USA, 42% in Australia, and 43% in Europe [1,2,3]
Twelve papers including in total 305,652 participants were considered eligible [16,17,31,32,33,34,35,36,37,38,39,40]. These studies had been conducted in 22 different countries, 9 of them were based in Europe, 2 in Asia, and 1 collected data from participants based in America, Africa, Asia, and Europe
The increased risk of psychosis for children of separated parents is consistent with the increased risk for those exposed to other childhood adversities, such as sexual, emotional, physical abuse, or neglect, reported in another systematic review [10]
Summary
The dissolution of marriage is common, affecting 46% of married couples in the USA, 42% in Australia, and 43% in Europe [1,2,3]. Evidence reported in two other systematic reviews shows an increased risk of psychosis in people who have experienced other adversities during childhood such as physical or sexual abuse [10,11]. The studies on the associations between parental separation and psychosis have not been critically appraised or summarized. The association between other adverse childhood experiences and an increased risk of psychosis has been reported. Cohort, case–control, and cross-sectional studies, comparing the risk of psychotic disorders for people with and without separated parents, were searched, critically appraised, and summarized. The five cohort studies included in this review showed and increased risk of psychosis with odds ratio: 1.47 (95% CI: 1.26–1.69), p < 0.001. Parental separation is a common childhood adversity associated with an increased risk of psychosis. Further studies on the risk of psychosis in those with separated parents, and the explanatory factors for this association, are required
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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
