Mortality Risk Among Offspring of Psychiatric Inpatients: A Population-Based Follow-Up to Early Adulthood

• Published in: The American journal of psychiatry 2006-12, Vol.163 (12), p.2170-2177
• Main Authors: Webb, Roger T., Abel, Kathryn M., Pickles, Andrew R., Appleby, Louis, King-Hele, Sarah A., Mortensen, Preben B.
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Adult Children; Age Factors; Alcoholism - epidemiology; Biological and medical sciences; Cause of Death; Child of Impaired Parents - statistics & numerical data; Cohort Studies; Denmark - epidemiology; Fathers - psychology; Fathers - statistics & numerical data; Female; Follow-Up Studies; Hospitalization; Humans; Infant mortality; Infant, Newborn; Male; Medical sciences; Mental Disorders - epidemiology; Mental Disorders - psychology; Miscellaneous; Mood Disorders - epidemiology; Mood Disorders - psychology; Mortality; Mothers - psychology; Mothers - statistics & numerical data; Parents & parenting; Prevalence; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Registries; Risk; Risk Factors; Schizophrenia - epidemiology; SIDS; Studies; Sudden infant death syndrome
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/ajp.2006.163.12.2170

Objective: The purpose of this article was to estimate relative risks of all-cause mortality associated with parental psychiatric disorder based on offspring age (up to 25 years of age), parental diagnosis, maternal versus paternal disorder, and number of affected parents. Method: The study group consisted of all Danish singleton live and stillbirths (N=1.46 million) during 1973-1998, identified using the Central Population Register and Medical Birth Register. Dates of death were recorded with follow-up to Jan. 1, 1999. Parental admission histories since 1969 were obtained from the Psychiatric Central Register. Results: Mortality risks were elevated from birth through early adulthood among offspring of people admitted with any type of psychopathology, although relative risks were attenuated during school attendance years. Effect sizes varied according to offspring ages, the highest being during infancy. The following high-risk subgroups were identified: postneonates with two mentally ill parents, neonates and postneonates whose mothers had alcohol and drug-related disorders, and neonates whose mothers had affective disorders. In general, from the postneonatal period onward, there was no indication that maternal psychopathology is associated with higher offspring mortality risk than paternal disorder. Conclusions: The greatest number of excess deaths were attributable to alcohol-related disorders, this being the most prevalent paternal diagnostic category and the second most prevalent in mothers. Some findings were unexpected. For example, there was no evidence that mortality risk among offspring of parents with schizophrenia and related disorders was significantly greater than that associated with all other parental psychiatric conditions, whereas the relative risk for neonatal death associated with maternal affective disorders was markedly raised.