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Bereavement after sibling death: a population-based longitudinal case-control study.

Abstract：

:The objective of this study was to examine mental disorders and treatment use among bereaved siblings in the general population. Siblings (N=7243) of all deceased children in the population of Manitoba, Canada who died between 1984 and 2009 were matched 1:3 to control siblings (N=21,729) who did not have a sibling die in the study period. Generalized estimating equations were used to compare the two sibling groups in the two years before and after the index child's death on physician-diagnosed mental disorders and treatment utilization, with adjustment for confounding factors including pre-existing mental illness. Analyses were stratified by age of the bereaved (<13 vs. 13+). Results revealed that, in the two years after the death of the child, bereaved siblings had significantly higher rates of mental disorders than control siblings, even after adjusting for pre-existing mental illness. When comparing the effect of a child's death on younger versus older siblings, the rise in depression rates from pre-death to post-death was significantly higher for siblings aged under 13 (p<0.0001), increasing more than 7-fold (adjusted relative rate, ARR=7.25, 95% CI: 3.65-14.43). Bereaved siblings aged 13+ had substantial morbidity in the two years after the death: 25% were diagnosed with a mental disorder (vs. 17% of controls), and they had higher rates of almost all mental disorder outcomes compared to controls, including twice the rate of suicide attempts (ARR=2.01, 95% CI: 1.29-3.12). Siblings in the bereaved cohort had higher rates of alcohol and drug use disorders already before the death of their sibling. In conclusion, the death of a child is associated with considerable mental disorder burden among surviving siblings. Pre-existing health problems and social disadvantage do not fully account for the increase in mental disorder rates.

journal_name

World Psychiatry

journal_title

World psychiatry : official journal of the World Psychiatric Association (WPA)

authors

Bolton JM,Au W,Chateau D,Walld R,Leslie WD,Enns J,Martens PJ,Katz LY,Logsetty S,Sareen J

doi

10.1002/wps.20293

subject

Has Abstract

pub_date

2016-02-01 00:00:00

pages

59-66

issue

eissn

1723-8617

issn

2051-5545

journal_volume

pub_type

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Bereavement after sibling death: a population-based longitudinal case-control study.