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Exposure to parental psychopathology and offspring's risk of suicide-related thoughts and behaviours: a systematic review

Published online by Cambridge University Press:  27 July 2017

S. M. Goodday ,
J. Shuldiner ,
S. Bondy  and
A. E. Rhodes
S. M. Goodday*
Affiliation:
Department of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
J. Shuldiner
Affiliation:
Department of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
S. Bondy
Affiliation:
Department of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
A. E. Rhodes
Affiliation:
Department of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada Department of Psychiatry, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada McMaster University, The Offord Centre for Child Studies, Hamilton, Ontario, Canada
*
*Address for correspondence: S. Goodday, Ph.D. candidate, Department of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada. (Email: Sarah.goodday@mail.utoronto.ca)
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Abstract

Aims.

The primary objective of this systematic review was to identify and synthesise analytic studies examining the association between exposure to parental psychopathology in childhood and the nature of subsequent suicide-related thoughts (SRT) and suicide-related behaviour (SRB) (severity of ideation, planned/unplanned attempts/lethality) and to describe the direction, and magnitude of associations. The secondary objective was to determine if the associations from the primary objective differ by the type(s) and timing of parental psychopathology, sex/gender of the parent and child and is mediated by child psychiatric symptoms and family functioning.

Methods.

A systematic review was conducted using guidelines from the PRISMA statement. MEDLINE, CINAHL, EMBASE, psycINFO, Web of Science and grey literature sources were searched by two reviewers to March, 2017. Studies were included if they examined any parental psychopathology (Diagnostic and Statistical Manual of Mental Disorders criteria or equivalent) or SRT or SRB and offspring SRT or SRB occurring from birth <25 years of age.

Results.

Out of 10 231 studies identified, 54 were included for review. Studies were clinically and methodologically heterogeneous with none at low risk of bias (ROB). Nine studies with moderate ROB indicated a significantly increased risk of offspring SRT, suicide attempts (SA) and suicide among those exposed to maternal SA and suicide in childhood or adolescence. In the remaining 45 studies with higher ROB this association persisted. Several studies (67%) did not confirm that the exposure occurred in the offspring's childhood or adolescence. Findings were suggestive of a mediating effect of offspring psychiatric symptoms, however, few studies examined mediation and effect modification of contextual variables.

Conclusions.

Offspring exposed to maternal SA are at an increased risk of these same behaviours early in life. Prospective attention to the types and timing of maternal and paternal psychopathology and the intermediate pathways to offspring SRT and SRB onset is needed and could have implications for informing modifiable targets for early intervention and prevention.

Keywords

Adolescencegender differencesmental healthsuicidesystematic reviews
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 28 , Issue 2 , April 2019 , pp. 179 - 190
Copyright
Copyright © Cambridge University Press 2017 

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