Sudden Parental Death Significantly Increases Incident Depression in Offspring

Incidence of depression occurred mostly within the first 2 years after parental death in patients whose parent died at the age of 12 or younger.

Incident depression is higher among offspring who have experienced the sudden death of a parent, according to a study published in the American Journal of Psychiatry. This research underlines the importance of prompt treatment for depression in bereaved children.

This study included 216 youths who had experienced the abrupt loss of a parent to suicide, sudden natural death, or accident, as well as 172 youths who were not bereaved. The study included a 7-year follow-up period. Bereaved offspring had a depression incidence rate ratio (IRR) of 2.08 (95% CI, 1.45-3.03) compared with non-bereaved youths in the first 2 years after parental death (IRR 3.13; 95% CI, 1.89-5.40), but this effect did not sustain after 2 years (IRR 1.24; 95% CI, 0.70-2.20). Depression was higher in those experiencing bereavement, even with adjustments for risk variables prior to death (hazard ratio 2.67; 95% CI, 1.58-4.51).  The incident depression was increased in offspring who lost a parent at the age of 12 or younger (HR 4.92; 95% CI, 2.04-11.87).  There was a significant increase in the incidence of depression in offspring whose parents died by suicide and by sudden natural death but not in offspring bereaved by accidental death.  

Before the death of a parent, youths who were bereaved had significantly more maltreatment, psychiatric disorder, and psychiatric disorder among parents. Cox and mixed-effects logistic regression and structural modeling of equations were used to evaluate the prevalence of disorder, functional impairment, and pathways to impairment. Youths suffering bereavement experienced significantly higher impairment at all points in time.

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The study researchers conclude that “[parental] death increased the incidence of depression in offspring early in the course of bereavement. Early identification and treatment of depression in bereaved youths and augmentation of family resilience may protect against later sequelae of functional impairment.”


Pham S, Porta G, Biernesser C, et al. The burden of bereavement: Early-onset depression and impairment in youths bereaved by sudden parental death in a 7-year prospective study [published online June 20, 2018]. Am J Psychiatry. doi: 10.1176/appi.ajp.2018.17070792