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Cited by 50Suicide and Self-Harm StudiesGrief, Bereavement, and Mental HealthHomicide, Infanticide, and Child Abuse

Offspring’s risk for suicidal behaviour in relation to parental death by suicide: systematic review and meta-analysis and a model for familial transmission of suicide.

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Calderaro, Mara, Baethge, Christopher, Bermpohl, Felix, Gutwinski, Stefan, Schouler-Ocak, Meryam, Henssler, Jonathan·2022·The British Journal of Psychiatry
DOI 10.1192/bjp.2021.158
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Abstract

BACKGROUND: Exposure to parental suicide has been associated with increased risk for suicide and suicide attempts, although the strength of this association is unclear as evidence remains inconsistent. AIMS: To quantify this risk using meta-analysis and identify potential effect modifiers. METHOD: A systematic search in PubMed, PsycInfo and Embase databases to 2020 netted 3614 articles. Inclusion criteria were: observation of history of parental death by suicide, comparison with non-exposed populations and definition of suicide and suicide attempt according to standardised criteria. We focused on population-based studies. The primary outcome was the pooled relative risk (RR) for incidence of suicide attempt and suicide in offspring of a parent who died by suicide compared with offspring of two living parents. Additionally, we compared the RR for attempted and completed suicide after parental suicide with the RR for attempted and completed suicide after parental death by other causes. RESULTS: Twenty studies met our inclusion criteria. Offspring exposed to parental suicide were more likely to die by suicide (RR = 2.97, 95% CI 2.50-3.53) and attempt suicide (RR = 1.76, 95% CI 1.58-1.96) than offspring of two living parents. Furthermore, their risk of dying by or attempting suicide was significantly higher compared with offspring bereaved by other causes of death. CONCLUSIONS: The experience of losing a parent to suicide is a strong and independent risk factor for suicidal behaviour in offspring. Our findings highlight the need for prevention strategies, outreach programmes and support interventions that target suicide-related outcomes in the exposed population.

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  • Household socioeconomic stressors and sociodemographic characteristics remain understudied in low-income settings where risks may be amplified.

    “In contrast, household socioeconomic stressors and sociodemographic characteristics remain understudied in low-income settings where risks may be amplified.17”

    From Mortality Risk Following a Household Suicide (2025) · cites this paper as [17]

    The Environmental factors section links suicidal behaviour to socioeconomic disadvantage and says socioeconomic factors modified effects in many included studies. Strength and limitations notes that 16 of 20 studies were Scandinavian and calls for further investigation in other countries. It does not specifically establish that household socioeconomic stressors and sociodemographic characteristics are understudied in low-income settings, or that risks are amplified there (page numbers unavailable). (LLM, conf=0.84)

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  • Research has largely focused on suicide risk among bereaved relatives, though less is known about how many people are exposed and need support in the broader household or about their overall mortality risk from nonsuicide causes.

    “Research has largely focused on suicide risk among bereaved relatives,2,14,15,16,17,18,19,20,21,22,23,24,25 though less is known about how many people are exposed and need support in the broader household19 or about their overall mortality risk from nonsuicide causes.9,26,27,28”

    From Mortality Risk Following a Household Suicide (2025) · cites this paper as [17]

  • Most evidence comes from high-income countries, where more robust health systems may buffer harms.

    “Most evidence comes from high-income countries,2,9,14,15,16,17,18,19,20,21,22,23,24,26,27,28 where more robust health systems may buffer harms.”

    From Mortality Risk Following a Household Suicide (2025) · cites this paper as [17]

  • Few population-based studies have examined these outcomes.

    “However, few population-based studies have examined these outcomes.17,19”

    From Mortality Risk Following a Household Suicide (2025) · cites this paper as [17]

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Research works printed but not linked: 2

  1. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta- analysis of observational studies in epidemiology -a proposal for reporting. JAMA 2000; 283: 2008-12.
  2. Lee K-Y, Li C-Y, Chang K-C, Lu TH, Chen YY. Age at exposure to parental suicide and the subsequent risk of suicide in young people. Crisis 2018; 39: 27-36.

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Authors
Calderaro, M., Baethge, C., Bermpohl, F., Gutwinski, S., Schouler-Ocak, M., & Henssler, J.
Affiliations
  • Stiftung Charité (DE)
  • University of Cologne (DE)
  • Charité – Universitätsmedizin Berlin (DE)
Corresponding author
Henssler, Jonathan
ORCID
Venue
The British Journal of Psychiatry
Publisher
Royal College of Psychiatrists
Published
2021-11-05
Volume
220
Issue
3
Pages
121-129
ISSN
  • 0007-1250 (ISSN-L)
  • 1472-1465
DOI
10.1192/bjp.2021.158
OpenAlex
W3212367399
Cited by
50
References
75
Citations by year
2026: 11 · 2025: 13 · 2024: 17 · 2023: 5 · 2022: 4
FWCI
0.86
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • The British Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords
parental suicide, suicide attempts, bereavement, suicide prevention, suicide risk factors, parental death
MeSH terms
Humans, Risk Factors, Suicide, Attempted, Child of Impaired Parents, Suicidal Ideation, Parental Death

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