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Am Fam Physician. 2004;69(4):986-987

Certain theories have suggested that the presence of children reduces the likelihood of suicide in parents. These theories have not been well supported in the literature. In one study, the more children a woman had, the less likely she was to commit suicide. Results of another study showed that having a child younger than two years in the home reduced the likelihood of parental suicide. However, no studies have examined the impact that the loss of a child could have on suicide risk in parents. The literature provides little information about the effect that psychiatric illness in children can have on parents. Qin and Mortensen investigated the impact of parental status on suicide risk, taking into account the number of children, the age of the youngest child, the psychiatric status of a child, the age at and mode of death of a child, and the time since the loss of a child.

The nested case-control study of four Danish longitudinal registers included all persons who committed suicide during the study period. These persons were matched for age, sex, and calendar time with persons from the general population to create a control group. To identify the presence of children, data from the national civil registry system were reviewed. This system included information that links the mother and father to their child at birth. In addition, the authors reviewed the national psychiatric register to determine whether any children had been admitted for psychiatric disorders. The data were summarized into four main categories: number of children, age of the youngest child, presence of psychiatric illness in children, and death in children.

A total of 18,611 persons completed suicide during the study period and were matched with 372,220 control subjects. Having a child protected parents against suicide risk. This finding was particularly true if the child was younger but was true even when other variables were controlled in the analysis. The protective effect was much stronger in women than it was in men. Parents whose child had been hospitalized for a psychiatric disorder or who had died were found to be at a higher risk for the completion of suicide. The strongest effect of childhood death on suicide was seen when the child was younger. The risk of parental suicide also was higher if the child's death was the result of a suicide. The highest risk of suicide in a parent occurred in the first month after the death of a child.

The authors conclude that the presence of children can protect parents against suicide risk. They add that it also can have a negative impact on that risk if a child dies, particularly during the younger years.

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