Tuesday, June 11, 2019

Children Whose Parents Have SMI Face Greater Risk of Self-Harm, Somatic Illness, Death

Children who have a parent with a serious mental illness (SMI) are at a greater risk of physical illnesses and death, according to a report in Schizophrenia Bulletin, highlighting the need for greater support of these children by the mental health community.

“Genetic vulnerability and lifestyle could be playing a role in the children’s increased risk,” wrote Anne Ranning, Ph.D., of Copenhagen University Hospital and colleagues. “Children may adapt to parents’ behavioral disposition with regard, for instance, to physical activity, smoking habits, and dietary patterns. Moreover, it has been suggested that SMI might in some cases be linked to a dysfunction in the immune system, which may also affect the child’s risk of general medical illnesses.”

The researchers conducted a register-based nationwide study of more than 2 million children born in Denmark between 1982 and 2012. These children were followed until their first hospital visit for a somatic illness or until their death. The maximum age of the offspring at follow-up was 30 years. Outcomes for children with a parent with SMI (parent had been diagnosed with depression, bipolar disorder, or schizophrenia) were then compared with outcomes for children whose parents did not have SMI.

Having at least one parent with SMI was associated with a 17% increase in likelihood of hospital contact for physical illness and a 31% increase in mortality rate compared with children whose parents did not have SMI, Ranning and colleagues reported. Compared with children who did not have a parent with SMI, those whose mothers had depression had a 22% greater risk of a hospital visit for physical illness, while those whose mothers had bipolar disorder had more than double the risk of death. Furthermore, the authors found that children whose parents had SMI and comorbid substance abuse were at higher risk for somatic illness and death.

Children with parents with SMI were more likely to have a variety of conditions, including endocrine/metabolic diseases, infections, and injury, the researchers found. The greatest risk of injury among children with a parent with SMI was intentional self-harm.

“Due to their increased risk of mental disorders, the children of parents with mental illness constitute an at-risk population; hence, selective preventive interventions are widely recommended to shift expected trajectories toward mental illness and social adversity,” Ranning and colleagues wrote. They recommended interventions to reduce risk factors and promote resilience such as family therapy, parenting and problem-solving skills training, and emotional well-being skills training for children and parents.

For related information, see the Psychiatric Services article “Randomized Controlled Trial of an Internet-Based Educational Intervention for Mothers With Mental Illnesses: An 18-Month Follow-Up.”

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