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Loved one's unexpected death increased psychiatric disorder risk

The unexpected death of a loved one was associated with the onset of multiple psychiatric disorders, according to recent study results published by The American Journal of Psychiatry.

Katherine M. Keyes, PhD, assistant professor of epidemiology at Columbia University, and colleagues evaluated 27,534 people aged 5 to older than 70 years after the unexpected death of a loved one to determine the association between the loss and onset of DSM-IV disorders. Participants were divided into 14 age groups.

Katherine M. Keyes

Overall, 50.3% of participants reported the unexpected death of a loved one. Unexpected loss was also the most commonly reported type of potentially traumatic experience. Alcohol use disorder was the most common lifetime psychiatric disorder (35.9%; mean age at onset, 28.6 years), followed by major depressive episode (23.7%; mean age at onset, 32.8 years).

More than 30% of participants with one, two, three or four potentially traumatic experiences reported that the unexpected death of a loved one was the worst.

Increased odds of each mood and alcohol use disorder was associated with unexpected deaths, especially among older age groups. Onset frequency increased in the time period when the death occurred.

Participants with four or more unexpected deaths had 1.72 more times the number of total episodes of psychiatric disorders compared with participants without any unexpected deaths. Those with one, two or three unexpected deaths also had more total episodes of psychiatric disorders compared with participants without any unexpected deaths. Increases in frequency were especially noted for posttraumatic stress disorder and major depression episodes.

“In summary, we found a significant relationship between the onset of mood, anxiety, or alcohol use disorder and the unexpected death of a loved one,” the researchers wrote. “These results suggest bereavement may be a useful lens in examining the etiology of psychiatric illness.”

Further, the researchers said loss of close personal relationships should be considered when performing psychiatric assessments.

“Clinically, our results highlight the importance of considering a possible role for loss of close personal relationships through death in assessment of psychiatric disorders, especially among older adults without a prior history of mental disorder,” Keyes told Healio.com. — by Amber Cox

Disclosure: One researcher reports financial ties with Guilford Press. The study was funded in part by the National Institute on Alcohol Abuse and Alcoholism and the National Institute of Mental Health.