Skip to main content

Advertisement

SpringerLink
Log in

Testing the anniversary reaction: causal effects of bereavement in a nationwide follow-up study from Sweden

  • PSYCHIATRIC EPIDEMIOLOGY
  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

Lingering grief associated with the death of a loved one has been hypothesized to precipitate acute health events among survivors on anniversary dates. We sought to study excess mortality risk in parents around the death date and birth date of a deceased child as an indication of a “bereavement effect”. We conducted a population based follow-up study using Swedish registries including links between children and parents. All biological and Swedish-born parents who experienced the death of a minor child born were observed during the period 1973–2008 (n = 48,666). An increased mortality risk was found during the week of a child’s death among mothers who lost a child aged 0–17 years (SMRR = 1.46, 95 % CI 0.98–2.17). The association was stronger among mothers who lost a child aged 1–17 years (SMRR = 1.89, 95 % CI 0.97–3.67) as compared to those who lost an infant (SMRR = 1.29, 95 % CI 0.78–2.12). Cardiovascular diseases and suicides were overrepresented as causes of death in mothers who died around the anniversary. We found no significant increase in the mortality risk around the date of child’s birth, nor any suggestion of excess mortality risk among fathers, but rather a depression of paternal death (SMRR = 0.60, 95 % CI 0.34–1.03). Our study indicates an anniversary reaction among mothers who lost a young child. These results suggest that bereavement per se could have an effect on health and mortality which should be acknowledged by public health professionals working with bereaved people.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Li J, Precht DH, Mortensen PB, et al. Mortality in parents after death of a child in Denmark: a nationwide follow-up study. Lancet. 2002;361:363–7.

    Article  Google Scholar 

  2. Sanders CM. A comparison of adult bereavement in the death of a spouse, child, and parent. Omega. 1979;10:303–22.

    Google Scholar 

  3. Middleton W, Raphael B, Burnett P, et al. A longitudinal study comparing bereavement phenomena in recently bereaved spouses, adult children and parents. Aust Psychiatry. 1998;32:235–41.

    Article  CAS  Google Scholar 

  4. Sirki K, Saarinen-Pihkala UM, Hovi L. Coping of parents and siblings with the death of a child with cancer: death after terminal care compared with death during active anticancer therapy. Acta Paediatr. 2000;89:717–21.

    Article  CAS  PubMed  Google Scholar 

  5. McEwen BS. Protective and damaging effects of the stress mediators. N Engl J Med. 1998;338:171–9.

    Article  CAS  PubMed  Google Scholar 

  6. Eshtehardi P, Koestner SC, Adorjan P, et al. Transient apical ballooning syndrome—clinical characteristics, ballooning pattern, and long-term follow-up in a Swiss population. Int J Cardiol. 2009;135:370–5.

    Article  PubMed  Google Scholar 

  7. Cohen S, Kessler R, Gorden U. Strategies for measuring stress in studies of psychiatric and physical disorders. In: Cohen S, Kessler R, Gorden U, editors. Measuring stress. New York: Oxford University Press; 1995. p. 3–26.

    Google Scholar 

  8. Hendrickson KC. Morbidity, mortality, and parental grief: a review of the literature on the relationship between the death of a child and the subsequent health of parents. Palliat Support Care. 2009;7:109–19.

    Article  PubMed  Google Scholar 

  9. Rostila M, Saarela J. Time does not heal all wounds. Mortality following the death of a parent. J Marriage Fam. 2011;73:236–49.

    Article  Google Scholar 

  10. Kreicbergs U, Valdimarsdottir U, Onelov E, et al. Anxiety and depression in parents 4–9 years after the loss of a child owing to malignancy: a population-based follow-up. Psychol Med. 2004;34:1431–41.

    Article  PubMed  Google Scholar 

  11. Li J, Johansen C, Olsen J. Cancer survival in parents who lost a child: a nationwide study in Denmark. Br J Cancer. 2003;88:1698–701.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Li J, Hansen D, Mortensen PB, et al. Myocardial infarction in parents who lost a child: a nationwide cohort study in Denmark. Circulation. 2002;106:1634–9.

    Article  PubMed  Google Scholar 

  13. Murphy SA, Lohan J, Braun T, et al. Parents’ health, health care utilization, and health behaviours following violent deaths of their 12- to 28-year-old children: a prospective longitudinal analysis. Death Stud. 1999;23:589–616.

    Article  CAS  PubMed  Google Scholar 

  14. Olsen J, Li J, Precht DH. Hospitalization because of diabetes and bereavement: a national cohort study of parents who lost a child. Diabet Med. 2005;22:1338–42.

    Article  CAS  PubMed  Google Scholar 

  15. Qin P, Mortensen PB. The impact of parental status on the risk of completed suicide. Arch Gen Psychiatry. 2003;60:797–802.

    Article  PubMed  Google Scholar 

  16. Birenbaum LK, Stewart BJ, Philips DS. Health status of bereaved parents. Nurs Res. 1996;45:105–9.

    Article  CAS  PubMed  Google Scholar 

  17. Kvikstad A, Vatten LJ. Risk and prognosis of cancer in middle-aged women who have experienced the death of a child. Int J Cancer. 1996;67:165–9.

    Article  CAS  PubMed  Google Scholar 

  18. Li J, Johansen SP, Olsen J. Stroke in parents who lost a child. A nationwide follow-up study in Denmark. Neuroepidemiology. 2003;22:211–6.

    Article  CAS  PubMed  Google Scholar 

  19. Rubin SS. The death of a child is forever: the life course impact of child loss. New York: Cambridge University Press; 1993.

    Google Scholar 

  20. Hasui C, Kitamura T. Aggression and guilt during mourning by parents who lost an infant. Bull Menninger Clin. 2004;68:245–59.

    Article  PubMed  Google Scholar 

  21. Arnold J, Gemma PB, Cushman LF. Exploring parental grief: combining quantitative and qualitative measures. Arch Psychiatr Nurs. 2005;19:245–55.

    Article  PubMed  Google Scholar 

  22. Dyregrov A, Matthiesen SB. Parental grief following the death of an infant—a follow-up over one year. Scand J Psychol. 1991;32:193–207.

    Article  CAS  PubMed  Google Scholar 

  23. Martinson IM, Davies B, McClowry S. Parental depression following the death of a child. Death Stud. 1991;15:259–67.

    Article  Google Scholar 

  24. Vance JC, Najman JM, Thearle MJ, et al. Psychological changes in parents eight months after the loss of an infant from stillbirth, neonatal death, or sudden infant death syndrome—a longitudinal study. Pediatrics. 1995;95:933–8.

    Google Scholar 

  25. Umberson D, Chen M. Effects of a parent’s death on adult children: relationship salience and reaction to loss. Am Sociol Rev. 1994;59:152–68.

    Article  Google Scholar 

  26. Bowlby J. Attachment and loss, vol. 1. London: Hogarth; 1970.

    Google Scholar 

  27. Rossi AS, Rossi PH. Of human bonding: parent–child relations across the life course. New York: Aldine de Gruyter; 1990.

    Google Scholar 

  28. Rostila M, Saarela J, Kawachi I. Mortality in parents following the death of a child: a nationwide follow-up study from Sweden. J Epidemiol Community Health. 2012;66:927–33.

    Article  PubMed  Google Scholar 

  29. Rostila M, Saarela J, Kawachi I. The forgotten griever: a nationwide follow-up study of mortality subsequent to the death of a sibling. Am J Epidemiol. 2012;176:338–46.

    Article  PubMed  Google Scholar 

  30. Olmsted R, Poznanski EO. The “replacement child”: a saga of unresolved parental grief. J Pediatr. 1972;81:1190–3.

    Article  Google Scholar 

  31. Gabriel MA. Anniversary reactions: trauma revisited. Clin Soc Work J. 1992;20:179–92.

    Article  Google Scholar 

  32. Renvoize EB, Jain J. Anniversary reactions. Br J Psychiatry. 1986;148:322–4.

    Article  CAS  PubMed  Google Scholar 

  33. Barker E, O’Gorman JG, De Leo D. Suicide after a loss or around anniversary times. In: De Leo D, Cimitan A, Dyregov K, Grad O, Andriessen K, editors. Bereavement after traumatic death: helping the survivors. Göttingen: Hogrefe Publishing; 2014.

    Google Scholar 

  34. Bunch J, Barraclough B. The influence of parental death anniversaries upon suicide dates. Br J Psychiatry. 1971;118:621–6.

    Article  CAS  PubMed  Google Scholar 

  35. Legg C, Sherick I. The replacement child—a developmental tragedy: some preliminary comments. Child Psychiatry Hum Dev. 1976;7:113–226.

    Article  CAS  PubMed  Google Scholar 

  36. Raphael B, Martinek N. Assessing traumatic bereavement and posttraumatic stress disorder. In: Wilson JP, Keane TM, editors. Assessing psychological trauma and PTSD. New York: Guilford Press; 1997. p. 373–95.

    Google Scholar 

  37. Kaltman S, Bonanno GA. Trauma and bereavement: examining the impact of sudden and violent deaths. J Anxiety Disord. 2003;17:131–47.

    Article  PubMed  Google Scholar 

  38. Merlevede E, Spooren D, Henderick H, et al. Perceptions, needs and mourning reactions of bereaved relatives confronted with a sudden unexpected death. Resuscitation. 2004;61:341–8.

    Article  PubMed  Google Scholar 

  39. Parkes CM. Bereavement in adult life. BMJ. 1998;316:856–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  40. Milberg A, Olsson E-C, Jakobsson M, et al. Family members’ perceived needs for bereavement follow-up. J Pain Symptom Manage. 2008;1:58–69.

    Article  Google Scholar 

Download references

Acknowledgments

M.R. was funded by the Swedish Research Council (Grant No. 2011-1649).

Conflict of interest

None.

Ethical standard

The data used in this study was approved by the Regional Ethical Review board of Stockholm (No. 2014/415-31/5).

Author information

Authors and Affiliations

  1. Department of Sociology and Centre for Health Equity Studies, Stockholm University, 106 91, Stockholm, Sweden

    Mikael Rostila

  2. University of Helsinki and Åbo Akademi University, PO Box 311, 65101, Vaasa, Finland

    Jan Saarela

  3. Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115-6096, USA

    Ichiro Kawachi

  4. Clinical Epidemiology, Department of Medicine, Karolinska Institutet and Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sveavägen 160, 106 91, Stockholm, Sweden

    Anders Hjern

Authors
  1. Mikael Rostila
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jan Saarela
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ichiro Kawachi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anders Hjern
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mikael Rostila.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rostila, M., Saarela, J., Kawachi, I. et al. Testing the anniversary reaction: causal effects of bereavement in a nationwide follow-up study from Sweden. Eur J Epidemiol 30, 239–247 (2015). https://doi.org/10.1007/s10654-015-9989-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10654-015-9989-5

Keywords

Search

Navigation