The impact of parental status on the risk of completed suicide.

BACKGROUND: Although some studies suggest that parenthood is associated with a reduced suicide risk, the impact of children on parental suicide has rarely been documented.
METHODS: This study investigates the impact of parental status on the risk of completed suicide in the context of other risk factors. A nested case-control design is used, matching for age, sex, and calendar time. The study is based on 4 Danish longitudinal registers, including 18 611 suicides of individuals aged 18 to 75 years from January 1, 1981, to December 31, 1997, and 372 220 matched control subjects. Information about children and subject's individual background is retrieved and merged. Data are analyzed using conditional logistic regression, yielding odds ratios interpreted as incidence rate ratios.
RESULTS: The presence of children is protective against suicide in parents in terms of having children and, to a higher degree, having a young child; these effects exist even when adjusted for marital, socioeconomic, and psychiatric status; and their influences are much stronger in women than in men. At the same time, parents of children with a hospitalized psychiatric disorder and parents of children who have died are at an increased risk for suicide. A child dying during early childhood has a strong effect on suicide in parents, and a suicidal death of a child increases the risk of parental suicide more than a nonsuicidal death. The suicide risk is particularly high in the first month after losing a child.
CONCLUSIONS: The impact of children on parental suicide can be protective because of having children. It can also be negative, for example, when losing a child, particularly if the child dies during early childhood; the risk is particularly high during the first month after the loss.