Suicide following the death of a sibling: a nationwide follow-up study from Sweden

Objectives The death of a sibling can trigger grief and depression. Sibling deaths from external causes may be particularly detrimental, since they are often sudden. We aimed to examine the association between the death of an adult sibling from external causes and the risk of suicide among surviving...

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Main Authors: Ichiro Kawachi, Jan Saarela, Mikael Rostila
Format: Article
Language:English
Published: BMJ Publishing Group 2013-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/3/4/e002618.full
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author Ichiro Kawachi
Jan Saarela
Mikael Rostila
author_facet Ichiro Kawachi
Jan Saarela
Mikael Rostila
author_sort Ichiro Kawachi
collection DOAJ
description Objectives The death of a sibling can trigger grief and depression. Sibling deaths from external causes may be particularly detrimental, since they are often sudden. We aimed to examine the association between the death of an adult sibling from external causes and the risk of suicide among surviving siblings up to 18 years after bereavement. We adjusted for intrafamily correlation in death risks, which might occur because of shared genetics and shared early-life experiences of siblings in the same family.Design A follow-up study between 1981 and 2002 based on the total population.Setting Sweden.Participants Swedes aged 25–64 years (n=1 748 069).Primary and secondary outcome measures Suicide from the Swedish cause of death register.Results An increased risk of mortality from suicide was found among persons who had experienced the death of a sibling. In women, the suicide risk was 1.55 times that of non-bereaved persons (95% CI 0.99 to 2.44), and in men it was 1.28 times higher (95% CI 0.93 to 1.77). If one sibling committed suicide, the risk of the remaining sibling also committing suicide was 3.19 (95% CI 1.23 to 8.25) among women and 2.44 (95% CI 1.34 to 4.45) among men. Associations with other main causes of death—such as external other than suicide, cardiovascular diseases or cancer—were generally much smaller and statistically not significant in either sex. We found no clear support for a specific time pattern according to time since a sibling's death.Conclusions Our study provided evidence for suicide risk associated with the death of a sibling at adult age, revealing that bereaved persons’ risk of suicide is higher when siblings die from suicide, even when adjusting for intrafamily correlation in death risks.
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spelling doaj-art-453b6e995adb419c9e724c123b4c1d302025-02-06T19:55:09ZengBMJ Publishing GroupBMJ Open2044-60552013-04-013410.1136/bmjopen-2013-002618Suicide following the death of a sibling: a nationwide follow-up study from SwedenIchiro Kawachi0Jan Saarela1Mikael Rostila2professor of social epidemiologyAbo Akademi University, Abo, FinlandDepartment of Public Health Sciences, Stockholm University, Stockholm, SwedenObjectives The death of a sibling can trigger grief and depression. Sibling deaths from external causes may be particularly detrimental, since they are often sudden. We aimed to examine the association between the death of an adult sibling from external causes and the risk of suicide among surviving siblings up to 18 years after bereavement. We adjusted for intrafamily correlation in death risks, which might occur because of shared genetics and shared early-life experiences of siblings in the same family.Design A follow-up study between 1981 and 2002 based on the total population.Setting Sweden.Participants Swedes aged 25–64 years (n=1 748 069).Primary and secondary outcome measures Suicide from the Swedish cause of death register.Results An increased risk of mortality from suicide was found among persons who had experienced the death of a sibling. In women, the suicide risk was 1.55 times that of non-bereaved persons (95% CI 0.99 to 2.44), and in men it was 1.28 times higher (95% CI 0.93 to 1.77). If one sibling committed suicide, the risk of the remaining sibling also committing suicide was 3.19 (95% CI 1.23 to 8.25) among women and 2.44 (95% CI 1.34 to 4.45) among men. Associations with other main causes of death—such as external other than suicide, cardiovascular diseases or cancer—were generally much smaller and statistically not significant in either sex. We found no clear support for a specific time pattern according to time since a sibling's death.Conclusions Our study provided evidence for suicide risk associated with the death of a sibling at adult age, revealing that bereaved persons’ risk of suicide is higher when siblings die from suicide, even when adjusting for intrafamily correlation in death risks.https://bmjopen.bmj.com/content/3/4/e002618.full
spellingShingle Ichiro Kawachi
Jan Saarela
Mikael Rostila
Suicide following the death of a sibling: a nationwide follow-up study from Sweden
BMJ Open
title Suicide following the death of a sibling: a nationwide follow-up study from Sweden
title_full Suicide following the death of a sibling: a nationwide follow-up study from Sweden
title_fullStr Suicide following the death of a sibling: a nationwide follow-up study from Sweden
title_full_unstemmed Suicide following the death of a sibling: a nationwide follow-up study from Sweden
title_short Suicide following the death of a sibling: a nationwide follow-up study from Sweden
title_sort suicide following the death of a sibling a nationwide follow up study from sweden
url https://bmjopen.bmj.com/content/3/4/e002618.full
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