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Depression among Pa...
Depression among Parents Two to Six Years Following the Loss of a Child by Suicide: A Novel Prediction Model
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- Nyberg, T. (author)
- Karolinska Institutet,Karolinska institutet
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- Myrberg, I. H. (author)
- Karolinska Institutet,Karolinska institutet
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- Omerov, Pernilla (author)
- Ersta Sköndal högskola,Karolinska Institutet,Institutionen för vårdvetenskap
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- Steineck, Gunnar, 1952 (author)
- Karolinska Institutet,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för onkologi,Institute of Clinical Sciences, Department of Oncology,Karolinska institutet; Sahlgrenska akademin, Göteborgs universitet
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- Nyberg, U. (author)
- Karolinska institutet
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(creator_code:org_t)
- 2016-10-03
- 2016
- English.
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In: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 11:10
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Abstract
Subject headings
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- Background Parents who lose a child by suicide have elevated risks of depression. No clinical prediction tools exist to identify which suicide-bereaved parents will be particularly vulnerable; we aimed to create a prediction model for long-term depression for this purpose. During 2009 and 2010 we collected data using a nationwide study-specific questionnaire among parents in Sweden who had lost a child aged 15-30 by suicide in years 2004-2007. Current depression was assessed with the Patient Health Questionnaire (PHQ-9) and a single question on antidepressant use. We considered 26 potential predictors assumed clinically assessable at the time of loss, including socio-economics, relationship status, history of psychological stress and morbidity, and suicide-related circumstances. We developed a novel prediction model using logistic regression with all subsets selection and stratified cross-validation. The model was assessed for classification performance and calibration, overall and stratified by time since loss. In total 666/915 (73%) participated. The model showed acceptable classification performance (adjusted area under the curve [AUC] = 0.720, 95% confidence interval [CI] 0.673-0.766), but performed classification best for those at shortest time since loss. Agreement between model-predicted and observed risks was fair, but with a tendency for underestimation and overestimation for individuals with shortest and longest time since loss, respectively. The identified predictors include female sex (odds ratio [OR] = 1.84); sick-leave (OR = 2.81) or unemployment (OR = 1.64); psychological premorbidity debuting during the last 10 years, before loss (OR = 3.64), or more than 10 years ago (OR = 4.96); suicide in biological relatives (OR = 1.54); with non-legal guardianship during the child's upbringing (OR = 0.48); and non-biological parenthood (OR = 0.22) found as protective. Our prediction model shows promising internal validity, but should be externally validated before application. Psychological premorbidity seems to be a prominent predictor of long-term depression among suicide-bereaved parents, and thus important for healthcare providers to assess.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Annan medicin och hälsovetenskap -- Övrig annan medicin och hälsovetenskap (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Other Medical and Health Sciences -- Other Medical and Health Sciences not elsewhere specified (hsv//eng)
Keyword
- psychiatric-illness
- bereaved parents
- traumatic grief
- risk-factor
- cohort
- death
- sweden
- recurrence
- morbidity
- severity
- Science & Technology - Other Topics
Publication and Content Type
- ref (subject category)
- art (subject category)
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