TOPLINE:

Children of parents with diseases of despair (DoD) — including substance use disorder, alcohol-related disease, or suicidal behavior — face nearly double the risk for suicidal events, with exposure to two affected parents or maternal DoD conveying higher risks.

METHODOLOGY:

• Researchers analyzed data from MarketScan commercial claims and encounter database of 164 million individuals from 2010 to 2020, identifying 561,837 families with at least one parent diagnosed with DoD and 1,180,546 control families.
• Analysis included 817,133 children from families with DoD (417,770 men; 383,810 aged 8-11 years) and 1,744,182 children from control families (889,308 men; 884,749 aged 8-11 years).
• The primary outcome measured child suicidal events, either a suicide attempt or self-harm, with follow-up until disenrollment or 730 days after parental DoD diagnosis.
• Data analysis utilized Cox proportional hazards model with inverse probability weighting to balance families with and without DoD for potential confounders.

TAKEAWAY:

• Exposure to parental DoD was associated with an increased hazard for suicidal events (hazard ratio [HR], 1.67; 95% CI, 1.54-1.82) in offspring.
• Children with two parents affected by DoD showed approximately double the hazard compared with those with one affected parent (interaction HR, 1.95; 95% CI, 1.58-2.39).
• Girls aged 8-11 years demonstrated a significant interaction with parental DoD (HR, 3.12; 95% CI, 2.05-4.74), whereas no significant association was found in boys of the same age (HR, 0.99; 95% CI, 0.63-1.54).
• Maternal DoD conveyed a higher risk for child suicidal events compared with paternal DoD (interaction HR, 1.44; 95% CI, 1.13-1.84).

IN PRACTICE:

“Improved access to care for parents with DoD and systematic screening and referral of their offspring could help to reduce the adolescent suicide rate,” the authors of the study wrote.

SOURCE:

This study was led by David A. Brent, MD, Department of Psychiatry, University of Pittsburgh School of Medicine in Pittsburgh. It was published online on September 12 in JAMA Network Open.

LIMITATIONS:

This study was limited by its focus on individuals with private insurance, which may not be representative of the general US population. The researchers noted that deaths of despair were initially more common among poorer, less educated individuals, suggesting potentially higher rates among those with Medicaid or no insurance. Additionally, the database only captured individuals who received treatment, not all affected persons. This study lacked race and ethnicity data, limiting the ability to examine health disparities, and could not establish whether parents and children were biologically related.

DISCLOSURES:

This study received support from the National Institute of Mental Health (grant No. PSO MH115838). Brent disclosed receiving personal fees from UpToDate as editor and eRT for an electronic version of the Columbia Suicide Severity Rating Scale, as well as grants from the Pittsburgh Foundation for pilot funds outside the submitted work. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.