The incidence and course of depression in bereaved youth 21 months after the loss of a parent to suicide, accident, or sudden natural death
Open accessAbstract
OBJECTIVE: This study examined effects of bereavement 21 months after a parent's death, particularly death by suicide. METHOD: The participants were 176 offspring, ages 7-25, of parents who died by suicide, accident, or sudden natural death. They were assessed 9 and 21 months after the death, along with 168 nonbereaved subjects. RESULTS: Major depression and alcohol or substance abuse 21 months after the parent's death were more common among bereaved youth than among comparison subjects. Offspring with parental suicide or accidental death had higher rates of depression than comparison subjects; those with parental suicide had higher rates of alcohol or substance abuse. Youth with parental suicide had a higher incidence of depression than those bereaved by sudden natural death. Bereavement and a past history of depression increased depression risk in the 9 months following the death, which increased depression risk between 9 and 21 months. Losing a mother, blaming others, low self-esteem, negative coping, and complicated grief were associated with depression in the second year. CONCLUSIONS: Youth who lose a parent, especially through suicide, are vulnerable to depression and alcohol or substance abuse during the second year after the loss. Depression risk in the second year is mediated by the increased incidence of depression within the first 9 months. The most propitious time to prevent or attenuate depressive episodes in bereaved youth may be shortly after the parent's death. Interventions that target complicated grief and blaming of others may also improve outcomes in symptomatic youth with parental bereavement.
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Suicide is a major global public health issue with profound impacts that extend beyond the deceased to surviving family members.
“Suicide is a major global public health issue with profound impacts that extend beyond the deceased to surviving family members.1,2,3,4”
From Mortality Risk Following a Household Suicide (2025) · cites this paper as [3]
The Discussion reports higher rates of depression and substance abuse among youth bereaved by parental suicide, supporting an impact on surviving family members. The paper does not establish that suicide is a major global public health issue, and its findings concern offspring rather than surviving family members generally. Page numbers were not available in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredChildren of parents who died by suicide (or in an accident) had higher rates of current and incident depression up to 21 months after the death than the non-bereaved and children of parents who died by sudden natural death.
“For example, Brent et al. [18] showed that children of parents who died by suicide (or in an accident) had higher rates of current and incident depression up to 21 months after the death than the non-bereaved and children of parents who died by sudden natural death.”
From Essential Questions on Suicide Bereavement and Postvention (2011) · cites this paper as [18]
The Results (Diagnoses and Symptoms 21 Months After Parent’s Death) report higher rates of current depression for both the suicide and accident groups than for nonbereaved subjects. The Results (Cumulative Incidence and Course of Depression) report higher incident depression from 9 to 21 months for the suicide group than for the sudden-natural-death group, but not for the accident group; they also report no significant cumulative-incidence differences among the three bereaved groups. The claim extends the suicide-group finding to the accident group and overstates the comparisons with sudden natural death. (LLM, conf=0.90)
Experimental — accuracy not yet measuredPreloss features such as history of psychiatric problems, feelings that others are accountable for the death, and postloss features such as quality of remaining parental relationship, and life events, affected the long-term mental health and developmental outcome.
“preloss features such as history of psychiatric problems, feelings that others are accountable for the death, and postloss features such as quality of remaining parental relationship, and life events, affected the long-term mental health and developmental outcome”
From Pre- and postloss features of adolescent suicide bereavement: A systematic review (2016) · cites this paper as Brent et al., 2009
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Experimental — accuracy not yet measuredChildren bereaved by suicide had a higher rate of alcohol or substance abuse.
“The children bereaved by suicide had also a higher rate of alcohol or substance abuse.”
From Essential Questions on Suicide Bereavement and Postvention (2011) · cites this paper as [18]
These factors contribute to depression, anxiety, PTSD, and substance use, thereby leading to early death.
“and contribute to depression, anxiety, PTSD, and substance use,3,4,5,6,7,8,9,10,11,18 thereby leading to early death.”
From Mortality Risk Following a Household Suicide (2025) · cites this paper as [3]
A longitudinal controlled follow-up of parentally bereaved adolescents found that preloss depression, PTSD at 9 months, and loss of mother predicted depression 2 years after the loss.
“a longitudinal controlled follow-up of parentally bereaved adolescents found that preloss depression, PTSD at 9 months, and loss of mother predicted depression 2 years after the loss (Brent et al., 2009)”
From Pre- and postloss features of adolescent suicide bereavement: A systematic review (2016) · cites this paper as Brent et al., 2009
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References 40 · Cited by 382
Research works printed but not linked: 1
- [25]Olsen DH Portner J Lavee Y Family Adaptability and Cohesion Evaluation Scales (FACES-II) 1985 Minneapolis University of Minnesota Press
- Authors
- Brent, D., Melhem, N., Donohoe, M. B., & Walker, M.
- Venue
- American Journal of Psychiatry
- Published
- 2009-07
- Volume
- 166
- Issue
- 7
- Pages
- 786-794
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC2768496
- OpenAlex
- W2163757710
- Cited by
- 382
- References
- 40
- Citations by year
- 2026: 17 · 2025: 12 · 2024: 15 · 2023: 17 · 2022: 30 · 2021: 36 · 2020: 27 · 2019: 26 · 2018: 31 · 2017: 24 · 2016: 29 · 2015: 12 · 2014: 24 · 2013: 21 · 2012: 24
- FWCI
- 21.54
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health and Human Services
- American Foundation for Suicide Prevention
- National Institute of Mental Health (MH-65638, R01MH065368)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- parental bereavement, adolescent depression, parental suicide, accidental death, sudden natural death, alcohol and substance abuse, complicated grief, blaming others, low self-esteem, negative coping, maternal loss, depression risk
- MeSH terms
- Accidents, Adult, Bereavement, Child, Death, Sudden, Depression, Humans, Parents, Surveys and Questionnaires, Severity of Illness Index, Suicide, Time Factors, Incidence, Prevalence, Age of Onset, Disease Progression, Young Adult
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