Alma Sörberg Wallin1, Hugo Sjöqvist2, Marina Dehara3, Michael B Wells4, Jennifer Dykxhoorn5, Kyriaki Kosidou2,6, Christina Dalman2,6. 1. Department of Global Public Health, Karolinska Institutet, Solnavägen 1C, 113 65, Stockholm, Sweden. alma.sorberg.wallin@ki.se. 2. Department of Global Public Health, Karolinska Institutet, Solnavägen 1C, 113 65, Stockholm, Sweden. 3. Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. 4. Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. 5. Division of Psychiatry and Department of Primary Care and Population Health, UCL, London, UK. 6. Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden.
Abstract
BACKGROUND: Previous studies suggest a protective effect of parenthood on suicide, but little is known about how the association may change across the lifespan, or in relation to sex, marital status or occurrence of psychiatric disorders. METHODS: We followed a cohort of over 5 million Swedish women and men, from 1991 to 2011, up to max. age 75, for death by suicide using national registers. Information on childbirths/adoptions, potential confounders and modifying factors were obtained from national registers. We assessed the associations between parenthood and suicide across adulthood using within time-stratified Cox regression models, with parenthood as a time-dependent exposure. RESULTS: Parents had a lower risk of suicide than non-parents across the lifespan, after adjusting for sociodemographic factors. The association was most pronounced in young adults, especially young women, but attenuated with increasing age and converged between sexes in older age groups. The lower risk of suicide over the life course was similar whether parents were married, unmarried or divorced, apart from married men; among them, parents only had a lower risk above age 55. The lower risk in parents was also evident in people with a history of psychiatric hospitalizations, but disappeared from age 55 in this population. CONCLUSION: The lower risk of suicide was present in both parents, was most pronounced in young adulthood and weakened with increasing age. Our results are consistent with a plausible mechanism where feelings of responsibility and connectedness are protective against suicide in parents.
BACKGROUND: Previous studies suggest a protective effect of parenthood on suicide, but little is known about how the association may change across the lifespan, or in relation to sex, marital status or occurrence of psychiatric disorders. METHODS: We followed a cohort of over 5 million Swedish women and men, from 1991 to 2011, up to max. age 75, for death by suicide using national registers. Information on childbirths/adoptions, potential confounders and modifying factors were obtained from national registers. We assessed the associations between parenthood and suicide across adulthood using within time-stratified Cox regression models, with parenthood as a time-dependent exposure. RESULTS: Parents had a lower risk of suicide than non-parents across the lifespan, after adjusting for sociodemographic factors. The association was most pronounced in young adults, especially young women, but attenuated with increasing age and converged between sexes in older age groups. The lower risk of suicide over the life course was similar whether parents were married, unmarried or divorced, apart from married men; among them, parents only had a lower risk above age 55. The lower risk in parents was also evident in people with a history of psychiatric hospitalizations, but disappeared from age 55 in this population. CONCLUSION: The lower risk of suicide was present in both parents, was most pronounced in young adulthood and weakened with increasing age. Our results are consistent with a plausible mechanism where feelings of responsibility and connectedness are protective against suicide in parents.
Authors: Kenneth S Kendler; Sara Larsson Lönn; Jessica E Salvatore; Jan Sundquist; Kristina Sundquist Journal: Psychol Med Date: 2018-10-25 Impact factor: 7.723
Authors: Jonas F Ludvigsson; Eva Andersson; Anders Ekbom; Maria Feychting; Jeong-Lim Kim; Christina Reuterwall; Mona Heurgren; Petra Otterblad Olausson Journal: BMC Public Health Date: 2011-06-09 Impact factor: 3.295
Authors: Marina Dehara; Michael B Wells; Hugo Sjöqvist; Kyriaki Kosidou; Christina Dalman; Alma Sörberg Wallin Journal: Acta Psychiatr Scand Date: 2020-10-19 Impact factor: 6.392