Growing in the shadows of suicide

Ana Vera Costa, Sandra Mendes, A. S. Pires, S. Melo, S. Borges, Joana Jorge, Graça Mendes
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Abstract

Introduction: Children/adolescents mourning the death of a primary caregiver face several challenges, including bond breaking and family restructuring due to loss. The negative connotation associated with suicide loss is enhanced by stigma, increasing acceptance difficulties and feelings of isolation, abandonment, shame, and guilt in face of what happened.Objective: The aim of this study was to retrieve data on childhood bereavement due to primary caregiver suicide and explore psychopathological and psycho-affective developmental consequences of this type of grief.Methods: Literature review of articles published on PubMed database about the subject.Results and Discussion: Bereavement of a suicidal parent is associated with multiple psychopathological conditions: mood disorders, post-traumatic stress disorder, substance abuse, self-injurious behavior, suicidal behavior. Suicide and depressive disorder risk is higher when parental death occurred early in life course, with maternal suicide having greater impact. Antidepressants are more commonly used in cases of early parental death from suicide and are associated with increased hospitalizations for Major Depression and Bipolar Affective Disorder in adulthood. Consequences of parental death by suicide may be explained by several factors, as genetics, biological reactions, psychological factors originated from loss of an attachment figure, or social and environmental changes.Conclusions: Parental suicide can be impactful for children’s developmental trajectory and later functioning level. The authors alert to the need for prevention and early intervention strategies associated with this process.
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在自杀的阴影中成长
导言:哀悼主要照顾者死亡的儿童/青少年面临着一些挑战,包括由于失去亲人而导致的纽带破裂和家庭重组。与自杀损失相关的负面内涵因耻辱、接受困难和面对所发生的事情的孤立、遗弃、羞耻和内疚感而增强。目的:本研究的目的是检索因主要照顾者自杀而导致的儿童丧亲的数据,并探讨这种类型的悲伤的精神病理和心理情感发展后果。方法:查阅PubMed数据库中已发表的相关文献。结果和讨论:自杀父母的丧亲之痛与多种精神病理状况有关:情绪障碍、创伤后应激障碍、药物滥用、自残行为、自杀行为。当父母在生命早期死亡时,自杀和抑郁障碍的风险更高,母亲自杀的影响更大。抗抑郁药更常用于父母早期自杀死亡的病例,并且与成年后因重度抑郁症和双相情感障碍住院治疗的增加有关。父母自杀死亡的后果可以用几个因素来解释,如遗传、生物反应、因失去依恋对象而产生的心理因素,或社会和环境变化。结论:父母自杀对儿童的发展轨迹和后期功能水平有影响。作者提醒需要预防和早期干预策略与此过程相关。
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