Abstract
Background: Bereavement is associated with impaired mental health, increases in adverse health behaviors, and heightened risk of suicidal ideation, attempts, and death by suicide. The purpose of this literature review was to explore associations between cause of death and suicidal thoughts among bereaved individuals. Our aim was to compare incidence of suicidal ideation by cause of death and identify gaps in this literature to guide future research and clinical intervention. Methods: PRISMA-P guidelines were used to structure an electronic literature search in the PsycINFO, MEDLINE, and Web of Science databases. The search focused on English language studies that were published before February 2019 and sought to compare rates of suicidal ideation among bereaved people who lost a loved one to suicide, accidental overdose, cancer, dementia, cardiovascular disease, and HIV/AIDs. Results: Nine articles were identified with suicide as cause of death, zero articles for accidental overdose, zero articles for cardiovascular disease, seven articles for cancer, one article for dementia, and one article for HIV/AIDs. Given the limited number of articles generated by our search, a formal meta-analysis was not appropriate. However, a comparison of results did suggest that suicide bereavement was associated with the highest rates of suicide ideation (14.1% to 49%). Stigma, isolation, avoidance behaviors, and psychological distress were associated with suicidal thoughts among bereaved individuals, regardless of the deceased’s cause of death. Conclusions: Findings of this literature search revealed significant gaps in the literature, especially regarding thoughts of suicide in bereaved survivors of accidental overdose and cardiovascular disease. Results suggest that multiple causes of death are associated with suicidal ideation in bereavement, but that suicide bereavement may be the cause of death associated with the highest risk of suicidal ideation. More research is needed to understand the ways in which cause of death influences prevalence, risk, and protective factors associated with suicidal thoughts among bereaved individuals.
Highlights
Bereavement has been shown to be associated with adverse health outcomes, including increased alcohol and tobacco consumption [1] and impairments in physical health, including increased risk of cardiovascular events [2] and heightened risk of mortality [3]
The included samples were comprised of individuals bereaved by suicide, accidental overdose, cancer, dementia, HIV/AIDs, or cardiovascular disease (CVD), and there were no specific criteria regarding comparison groups; bereaved samples included a mix of both bereaved informal caregivers and bereaved family members
Our search generated 7 articles on risk of suicidal ideation in suicide bereavement that fit the scope of this review, all published between 2005 and 2018
Summary
Bereavement has been shown to be associated with adverse health outcomes, including increased alcohol and tobacco consumption [1] and impairments in physical health, including increased risk of cardiovascular events [2] and heightened risk of mortality [3]. Bereavement poses risk of adverse mental health outcomes (e.g., anxiety, depression, and prolonged grief disorder (PGD)) [4,5,6]. PGD and quality of life/quality of death of the patient may affect bereaved informal caregivers’ mental health [10] and even their degree of suicidal ideation [11]. What remains less well-known and studied is the relationship between the deceased’s cause of death and the bereaved family caregiver’s risk of suicidal ideation. Bereavement is associated with impaired mental health, increases in adverse health behaviors, and heightened risk of suicidal ideation, attempts, and death by suicide. The purpose of this literature review was to explore associations between cause of death and suicidal thoughts among bereaved individuals. A comparison of results did suggest that suicide bereavement was associated with the highest rates of suicide ideation (14.1% to 49%)
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