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May 2008

Implications of Parental Bereavement and Other Family Adversities for Preventive and Health Promotion Pediatric Services

Arch Pediatr Adolesc Med. 2008;162(5):487-488. doi:10.1001/archpedi.162.5.487

The article by Melhem and coworkers “Antecedents and Sequelae of Sudden Parental Death in Offspring and Surviving Caregivers”1 is the most methodologically rigorous study to date of mental health disorders of parentally bereaved children. Their findings that sudden parental death is associated with an increased risk for child mental health problems as well as increased mental health problems for the surviving parent have significant implications for pediatric practice. Before considering implications it should be noted that the current findings on parental bereavement add to growing evidence from epidemiologic studies that other family adversities, such as parental divorce2 or parental psychiatric or substance abuse disorder,3,4 are also associated with elevated rates of disorder of children so that the implications for pediatric practice should include a wider range of childhood adversities. The findings on the relations between family adversities, including parental bereavement, and children's mental health confront us with 2 issues. (1) What are the implications for current pediatric practice? (2) How might these findings optimally be integrated into future pediatric practice?

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