Offspring of parents with severe mental illness (SMI) experience increased rates of mortality and somatic morbidity, warranting enhanced vigilance and support in this patient population. A register-based, nationwide cohort study on the subject was conducted in Denmark and the results of the analysis were published in the journal Schizophrenia Bulletin.

The investigators identified all children born in Denmark between 1982 and 2012, along with their parents. Children were defined as being exposed to SMI if their parents had a registered diagnosis of schizophrenia, bipolar disorder, or unipolar depression in the Danish Psychiatric Central Register from 1969 until the child’s first hospital contact within the specific diagnostic category. The oldest offspring evaluated were age 30 years at the conclusion of the study follow-up.

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A total of 2,000,694 children were included in the study. Of the 2,000,694 offspring, 1,741,898 had a hospital contact for a somatic condition during follow-up until 2012 (8,373,450 person-years of follow-up). Of these 1,741,898 children with somatic hospital contacts, 47,456 had ≥1 parent with SMI.

The study results demonstrated that the offspring of parents with SMI had an increased risk for somatic hospital contact (incidence rate ratio [IRR], 1.17; 95% CI, 1.16-1.18). In fact, maternal depression was associated with the highest IRR of 1.22 (95% CI, 1.20-1.24). Moreover, offspring of parents with SMI had a significantly increased risk within most broad diagnostic categories, with the highest IRRs reported for unclassified somatic diagnoses, infections, and endocrine diseases, which ranged from an IRR of 1.27 (95% CI, 1.25-1.28) to an IRR of 1.26 (95% CI, 1.231.29; P < .001 for all). Morbidity in the offspring was particularly increased in children between 0 and 7 years of age.

With respect to mortality, the overall mortality rate ratio associated with parental SMI was 1.31 (95% CI, 1.21-1.41). Excess mortality was due mainly to unnatural causes.

The investigators concluded that a focus on children’s general physical health could be incorporated beneficially into interventions aimed at targeting families with parental SMI.

Reference

Ranning A, Benros ME, Thorup AAE, et al. Morbidity and mortality in the children and young adult offspring of parents with schizophrenia or affective disorders—a nationwide register-based cohort study in 2 million individuals [published online June 8, 2019] . Schizophr Bull. doi:https://doi.org/10.1093/schbul/sbz040