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Original Investigation
October 2016

Parental Psychiatric Disease and Risks of Attempted Suicide and Violent Criminal Offending in OffspringA Population-Based Cohort Study

Author Affiliations
  • 1Centre for Mental Health and Safety, University of Manchester, Manchester, England
  • 2Centre for Integrated Register-Based Research, CIRRAU, Aarhus University, Aarhus, Denmark
  • 3National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, Aarhus, Denmark
  • 4The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
  • 5Institute of Population Health, University of Manchester, Manchester, England
  • 6Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
JAMA Psychiatry. 2016;73(10):1015-1022. doi:10.1001/jamapsychiatry.2016.1728

Importance  Self-directed and interpersonal violence share some common risk factors such as a parental history of mental illness. However, relationships between the full spectrum of parental psychiatric disease and these 2 related outcomes are unclear.

Objective  To examine associations between the full spectrum of parental psychiatric disease and risks of attempted suicide and violent offending among offspring.

Design, Setting, and Participants  Population-based cohort study of all persons born in Denmark 1967 through 1997, followed up from their 15th birthday until occurrence of adverse outcome or December 31, 2012, whichever came first.

Exposures  Array of parental psychiatric disorders and parental suicide attempt, delineated from records of secondary care treatments.

Main Outcomes and Measures  Using survival analyses techniques, incidence rate ratios were estimated for offspring suicide attempt and violent offending.

Results  We examined 1 743 525 cohort members (48.7% female; total follow-up, 27.2 million person-years). Risks for offspring suicide attempt and violent offending were elevated across virtually the full spectrum of parental psychiatric disease. Incidence rate ratios were the most elevated for parental diagnoses of antisocial personality disorder (suicide attempt, 3.96; 95% CI, 3.72-4.21; violent offending, 3.62; 95% CI, 3.41-3.84) and cannabis misuse (suicide attempt, 3.57; 95% CI, 3.25-3.92; violent offending, 4.05; 95% CI, 3.72-4.39), and for parental suicide attempt (suicide attempt, 3.42; 95% CI, 3.29-3.55; violent offending, 3.31; 95% CI, 3.19-3.44). Parental mood disorders (and bipolar disorder in particular) conferred more modest risk increases. A history of mental illness or suicide attempt in both parents was associated with double the risks compared with having just 1 affected parent. Associations between parental psychiatric disease and offspring violent offending were stronger for female than for male offspring, whereas little sex difference in risk was found for offspring suicide attempt.

Conclusions and Relevance  The similarities in risk patterns observed between the 2 outcomes may evidence a shared etiology. Early interventions to tackle parental mental disorders may be beneficial to both parents and children.