Growing in the shadows of suicide

Authors

  • Ana Vera Costa Department of Child and Adolescent Psychiatry, Centro Hospitalar Vila Nova de Gaia/Espinho https://orcid.org/0000-0001-7611-2154
  • Sandra Mendes Department of Child and Adolescent Psychiatry, Centro Hospitalar Vila Nova de Gaia/Espinho
  • Ana Sofia Pires Department of Child and Adolescent Psychiatry, Centro Hospitalar Vila Nova de Gaia/Espinho
  • Sara Melo Department of Child and Adolescent Psychiatry, Centro Hospitalar Vila Nova de Gaia/Espinho
  • Sandra Borges Department of Child and Adolescent Psychiatry, Centro Hospitalar Vila Nova de Gaia/Espinho
  • Joana Jorge Department of Child and Adolescent Psychiatry, Centro Hospitalar Vila Nova de Gaia/Espinho
  • Graça Mendes Department of Child and Adolescent Psychiatry, Centro Hospitalar Vila Nova de Gaia/Espinho

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v29.i1.18631

Keywords:

bereavement, parental death, suicide, transgenerational

Abstract

Introduction: Children/adolescents mourning the death of a primary caregiver face several challenges, including bond breaking and family restructuring due to loss. The negative connotation associated with suicide loss is enhanced by stigma, increasing acceptance difficulties and feelings of isolation, abandonment, shame, and guilt in face of what happened.
Objective: The aim of this study was to retrieve data on childhood bereavement due to primary caregiver suicide and explore psychopathological and psycho-affective developmental consequences of this type of grief.
Methods: Literature review of articles published on PubMed database about the subject.
Results and Discussion: Bereavement of a suicidal parent is associated with multiple psychopathological conditions: mood disorders, post-traumatic stress disorder, substance abuse, self-injurious behavior, suicidal behavior. Suicide and depressive disorder risk is higher when parental death occurred early in life course, with maternal suicide having greater impact. Antidepressants are more commonly used in cases of early parental death from suicide and are associated with increased hospitalizations for Major Depression and Bipolar Affective Disorder in adulthood. Consequences of parental death by suicide may be explained by several factors, as genetics, biological reactions, psychological factors originated from loss of an attachment figure, or social and environmental changes.
Conclusions: Parental suicide can be impactful for children’s developmental trajectory and later functioning level. The authors alert to the need for prevention and early intervention strategies associated with this process.

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References

Bowlby J. Loss, sadness and depression. Attachment and Loss, Volume III. Travistock Institute of Human Relations, 1980.

Freud S. Trauer und melancholie.. Translation, introduction and notes: Marilene Carone. São Paulo: Cosac Naify, 1ª electronic edition, 2013.

Golse B. Le developpment affetif et intellectuel de l’enfant. Translation: Emmanuel Pestana. Climepsi editores, 2005.

Schreiber JK, Sands DC, Jordan JR. The Perceived Experience of Children Bereaved by Parental Suicide. Omega (Westport). 2017; 75:184-206.

Hung NC, Rabin LA. Comprehending childhood bereavement by parental suicide: a critical review of research on outcomes, grief processes, and interventions. Death Stud. 2009; 33:781-814.

Cain AC. Parent suicide: pathways of effects into the third generation. Psychiatry. 2006; 69:204-27.

Geulayov G, Gunnell D, Holmen TL, Metcalfe C. The association of parental fatal and non-fatal suicidal behaviour with offspring suicidal behaviour and depression: a systematic review and meta-analysis. Psychol Med. 2012; 42:1567-80.

Brown AC, Sandler IN, Tein JY, Liu X, Haine RA. Implications of parental suicide and violent death for promotion of resilience of parentally-bereaved children. Death Stud. 2007; 31:301-35.

Janet Kuramoto S, Brent DA, Wilcox HC. The impact of parental suicide on child and adolescent offspring. Suicide Life Threat Behav. 2009; 39:137-51.

Wilcox HC, Kuramoto SJ, Lichtenstein P, Långström N, Brent DA, Runeson B. Psychiatric morbidity, violent crime, and suicide among children and adolescents exposed to parental death. J Am Acad Child Adolesc Psychiatry. 2010; 49:514-23

Rostila M, Berg L, Arat A, Vinnerljung B, Hjern A. Parental death in childhood and self-inflicted injuries in young adults-a national cohort study from Sweden. Eur Child Adolesc Psychiatry. 2016; 25:1103-11.

Kaplow JB, Howell KH, Layne CM. Do circumstances of the death matter? Identifying socioenvironmental risks for grief-related psychopathology in bereaved youth. J Trauma Stress. 2014; 27:42-9.

Cerel J, Fristad MA, Weller EB, Weller RA. Suicide-bereaved children and adolescents: a controlled longitudinal examination. J Am Acad Child Adolesc Psychiatry. 1999; 38:672-9.

Cerel J, Fristad MA, Weller EB, Weller RA. Suicide-bereaved children and adolescents: II. Parental and family functioning. J Am Acad Child Adolesc Psychiatry. 2000; 39:437-44.

Brent DA, Melhem NM, Masten AS, Porta G, Payne MW. Longitudinal effects of parental bereavement on adolescent developmental competence. J Clin Child Adolesc Psychol. 2012; 41:778-91.

Melhem NM, Porta G, Shamseddeen W, Walker Payne M, Brent DA. Grief in children and adolescents bereaved by sudden parental death. Arch Gen Psychiatry. 2011; 68:911-9.

Melhem NM, Walker M, Moritz G, Brent DA. Antecedents and sequelae of sudden parental death in offspring and surviving caregivers. Arch Pediatr Adolesc Med. 2008; 162:403-10.

Melhem NM, Moritz G, Walker M, Shear MK, Brent D. Phenomenology and correlates of complicated grief in children and adolescents. J Am Acad Child Adolesc Psychiatry. 2007; 46:493-9.

Kuramoto SJ, Stuart EA, Runeson B, Lichtenstein P, Långström N, Wilcox HC. Maternal or paternal suicide and offspring’s psychiatric and suicide-attempt hospitalization risk. Pediatrics. 2010; 126:e1026-32.

Guldin MB, Li J, Pedersen HS, Obel C, Agerbo E, Gissler M, et al. Incidence of Suicide Among Persons Who Had a

Parent Who Died During Their Childhood: A Population-Based Cohort Study. JAMA Psychiatry. 2015; 72:1227-34.

Burrell LV, Mehlum L, Qin P. Risk factors for suicide in offspring bereaved by sudden parental death from external causes. J Affect Disord. 2017; 222:71-78.

Burrell LV, Mehlum L, Qin P. Sudden parental death from external causes and risk of suicide in the bereaved offspring: A national study. J Psychiatr Res. 2018; 96:49-56.

Pitman A, Osborn D, King M, Erlangsen A. Effects of suicide bereavement on mental health and suicide risk. Lancet Psychiatry. 2014; 1:86-94.

Appel CW, Johansen C, Deltour I, Frederiksen K, Hjalgrim H, Dalton SO, et al. Early parental death and risk of hospitalization for affective disorder in adulthood. Epidemiology. 2013; 24:608-15.

Appel CW, Johansen C, Christensen J, Frederiksen K, Hjalgrim H, Dalton SO, et al. Risk of Use of Antidepressants Among Children and Young Adults Exposed to the Death of a Parent. Epidemiology. 2016; 27:578-85.

Tsuchiya KJ, Agerbo E, Mortensen PB. Parental death and bipolar disorder: a robust association was found in early maternal suicide. J Affect Disord. 2005; 86:151-9.

Hamdan S, Melhem NM, Porta G, Song MS, Brent DA. Alcohol and substance abuse in parentally bereaved youth. J Clin Psychiatry. 2013; 74:828-33.

Hamdan S, Mazariegos D, Melhem NM, Porta G, Payne MW, Brent DA. Effect of parental bereavement on health risk behaviors in youth: a 3-year follow-up. Arch Pediatr Adolesc Med. 2012; 166:216-23.

Brent D, Melhem N, Donohoe MB, Walker M. The incidence and course of depression in bereaved youth 21 months after the loss of a parent to suicide, accident, or sudden natural death. Am J Psychiatry. 2009; 166:786-94.

Weinberg RJ, Dietz LJ, Stoyak S, Melhem NM, Porta G, Payne MW, et al. A prospective study of parentally bereaved youth, caregiver depression, and body mass index. J Clin Psychiatry. 2013; 74:834-40.

Mitchell AM, Wesner S, Garand L, Gale DD, Havill A, Brownson L. A support group intervention for children bereaved by parental suicide. J Child Adolesc Psychiatr Nurs. 2007; 20:3-13.

Pfeffer CR, Jiang H, Kakuma T, Hwang J, Metsch M. Group intervention for children bereaved by the suicide of a relative. J Am Acad Child Adolesc Psychiatry. 2002; 41:505-13.

Spuij M, Dekovic M, Boelen PA. An open trial of ‘grief-help’: a cognitive-behavioural treatment for prolonged grief in children and adolescents. Clin Psychol Psychother. 2015; 22:185-92.

Sandler I, Tein JY, Wolchik S, Ayers TS. The Effects of the Family Bereavement Program to Reduce Suicide Ideation and/or Attempts of Parentally Bereaved Children Six and Fifteen Years Later. Suicide Life Threat Behav. 2016; 1:S32-8.

Journot-Reverbel K, Raynaud JP, Bui E, Revet A. Support groups for children and adolescents bereaved by suicide: Lots of interventions, little evidence. Psychiatry Res. 2017; 250:253-55.

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Published

2020-06-26

How to Cite

1.
Costa AV, Mendes S, Pires AS, Melo S, Borges S, Jorge J, Mendes G. Growing in the shadows of suicide. REVNEC [Internet]. 2020Jun.26 [cited 2024Apr.19];29(2):101-7. Available from: https://revistas.rcaap.pt/nascercrescer/article/view/18631

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