Parental psychiatric diseases may lead to risk for suicide attempts and violent offending by children

The JAMA Network JournalsAug 31 2016

Risk for suicide attempts and violent offending by children appears to be associated with their parents' psychiatric disorders, according to an article published online by JAMA Psychiatry.

Suicide and violent behaviors can cluster within families, possibly because of genetics, epigenetics, and social and environmental influences.

Roger T. Webb, Ph.D., of the University of Manchester, England, and coauthors examined associations between a full spectrum of parental psychiatric diseases (including mental disorders, dementia in Alzheimer disease, substance use disorders, schizophrenia, mood disorders, anxiety, personality disorders and suicide attempts) with attempted suicide and violent offending by children.

The study group included more than 1.7 million people born in Denmark from 1967 through 1997 and followed up from their 15th birthday. About 2.6 percent of the study population first attempted suicide and 3.2 percent were convicted of a first violent offense during the study period.

The authors report:

• Risks for suicide attempts and violent offending by children were elevated across virtually the entire spectrum of parental psychiatric disease.
• The greatest increases in risk for both suicide attempt and violent offending by children were associated with parental diagnoses of antisocial personality disorder, cannabis misuse and prior suicide attempt.
• Parental mood disorders, particularly bipolar disorder, were associated with some of the lowest increases in risk, especially in violent offending by children.
• A history of mental illness or suicide attempt in both parents was associated with twice the risk compared with having only one parent affected.
• Associations between parental psychiatric disease and violent offending by children were stronger for female than male children; suicide attempts by children were comparable regardless of sex.

The study notes its most important limitation is that although researchers accounted for parental socioeconomic status, they could not adjust for other mitigating factors such as parental criminal histories or experiences of abuse by those in the study group.

"The similarities in relative risk patterns observed for both adverse outcomes indicate that self-directed and interpersonal violence may have a shared etiology," the authors write.

The study notes children of parents with a history of psychiatric disease also are at increased of risk of being exposed to maladaptive parenting practice, family violence, abuse, neglect and financial hardship. The impact of those harmful environmental factors can be cumulative.

"Psychiatrists and other professionals treating adults with mental disorders and suicidal behavior should consider also evaluating the mental health and psychosocial needs of their patients' children. Early interventions could benefit not only the parents but also their offspring," the study concludes.