Mortality risk higher for children of mentally ill

A Danish population-based study suggests that the relative risk of death is statistically raised among children with one or two mentally ill parents, although the absolute risk is still low.

Principal investigator Roger T. Webb, research fellow at the University of Manchester Division of Psychiatry, UK, and colleagues analyzed the risk of death from any cause in children whose mother or father had been admitted for psychiatric treatment and compared them against mortality risks in the general population.

Analyses centered on 1.46 million Danish children born between 1973 and 1998 and were followed until age 25 years, as well as all psychiatric parental admissions occurring nationally since 1969.

According to Webb, “children whose parents were previously admitted for any psychiatric treatment were at greater risk of death from all causes, from birth right through to the early adulthood years (16-25 years), than their peers in the general population.”

Risks associated with having a mentally ill parent vary markedly by age, Webb and colleagues report in the American Journal of Psychiatry. Children of mentally ill parents are at higher risk of death during infancy and the years prior to attending school, and the risk increases again in early adulthood, they note.

“Older children may be partially protected against the ill effects of parental mental illness,” Webb observes.

Although the mortality risk varied by the age of the child, it was rarely more than twice as high as that of children without a mentally ill parent.

Risks also vary by diagnosis. In contrast to previous findings, “our findings suggest that maternal schizophrenia is no more hazardous (in terms of risk of death in infancy or childhood) than other forms of severe maternal mental illness,” Webb noted.

The data also suggest that “particularly high” infant mortality risks in the first year of life are linked with maternal alcohol and drug-related disorders, along with mood disorders, such as depression.

In general, having two mentally ill parents was associated with greater risk than having one mentally ill parent.

“The vast majority of mentally ill parents, including those suffering with severe disorders, pose no risk to the survival of their children,” Webb emphasized in an email to Reuters Health.

“Partly because these tragic events are so rare, their prediction and prevention remains a great challenge for clinicians and policymakers,” he also noted.

SOURCE: American Journal of Psychiatry. December 2006.

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