Sibling death in childhood and self-inflicted injuries in young adults – a national cohort study from Sweden

Abstract

Previous studies have shown that sibling death influences health and mortality in bereaved adult siblings. Few studies have so far examined whether exposure to sibling bereavement in childhood is associated with suicidality later in life. The aim of the present research was to investigate whether the loss of a sibling during childhood influences self-inflicted injuries/poisoning in young adulthood. A national cohort born during 1973–1982 ( n =717,723) was followed prospectively in the National Patient Discharge Register from 18 to 31–40 years of age. Multivariate Cox analyses of proportional hazards with adjustment for socio-demographic confounders and family covariates were used to test hypotheses regarding sibling loss and hospital admission due to self-inflicted injuries/poisoning. Men (HR: 1.28, 95% CI: 1.01–1.62) and women (HR: 1.23, 95% CI: 1.00–1.51) who had lost a sibling during childhood had an higher risk for being admitted to hospital for a self-inflicted injury/poisoning in young adulthood after adjustment for socio-demographic confounders and family risk factors. Losing an infant sibling was most detrimental for men (HR: 1.43, 95% CI: 1.03–1.98) while losing a non-infant sibling was most detrimental for women (HR: 1.38, 95% CI: 1.05–1.81). The risk of hospital admission due to self-inflicted injuries/poisoning was particularly detrimental for both men (HR: 1.40, 95% CI: 0.92–2.13) and women (HR: 1.54, 95% CI: 1.09–2.17) who lost a sibling in adolescence (12–18 years) when compared to loss at younger ages (0–5 years and 6–11 years). It is important to provide support for siblings bereaved in childhood in order to prevent suicides.