Long-term Consequences of Bereavement in Children, Adolescents and Young Adults

Bereavement in Children, Adolescents and Young Adults. - A Study of Health and Psychosocial Well-being in Adults Who Have Experienced Early Parental Death

The purpose of this study is to examine how the death of a parent as a child, adolescent or young adult affects health and psychosocial wellbeing in adult life and to evaluate the impact in adult life of counseling to children, adolescents and young adults who lost a parent.

Study Overview

• Status: Completed
• Conditions: Bereavement

Detailed Description

Early parental death experienced by 4% of the children in Western countries, is considered to be the most stressful and potentially harmful childhood life event and the health consequences may depend on the nature of the bereavement (e.g. relationship with bereaved), as well as by interpersonal (e.g. social support), intrapersonal (e.g. age and genetics), appraisal and coping factors. Studies have shown that children and adolescents have a greater risk of getting a psychiatric diagnose as well as psychological and social problems. Despite of the obvious consequences of losing a parent, there is a lack of systematic studies on the consequences later in life as well as studies that evaluate the counseling possibilities the children and adolescents are offered.

The study will investigate:

1. Long-term health effects of experiencing parental death as a child adolescent or young adult. Focus will be on psychiatric outcomes including depression, severe cardiovascular disease, suicide, suicide attempts, psychological well-being and health related behavior.
2. Long term effects of experiencing parental death as a child, adolescent or young adult on socioeconomic outcomes as education, employment, marital status/ cohabitation status and number of children/age when having children.
3. The long-term psychosocial and behavioral impact of psychological intervention programmes to children, adolescents and young adults who have experienced the death of a parent. Focus will be on: Depressive symptoms, quality of life, posttraumatic stress disorder, life style, relationship functioning, grief and spirituality.

A nationwide register based cohort of people born in Denmark will be established. Long-term health effects and socioeconomic outcomes of experiencing parental death will be based on nationwide clinical and administrative registries. Exposure is defined as experiencing the death of a parent before age 30. The long-term psychosocial and behavioral impact of psychological intervention programmes will be based on a combination of questionnaire data and data from registries.

The part of the study using data from registries will be based on the nationwide cohort. The questionnaire based part of the study will include 3 groups selected from the nationwide cohort:

1. Persons who have lost a parent and participated in intervention programmes (identified through counseling centers),
2. Persons who have lost a parent, and not participated in intervention programmes (randomly selected matched on age and gender) and
3. Persons who have not lost a parent (randomly selected matched on age and gender).

An invitation letter will be send to the 3 groups (5500 persons) by mail, and they will be asked to complete one questionnaire online.

• Study Type: Observational
• Enrollment (Actual): 1225660

Contacts and Locations

Study Locations

• Denmark
  • Copenhagen, Denmark, 2100
    • Department of Psychosocial Cancer Research, Institute of Cancer Epidemiology, Danish Cancer Society

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 11 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Nationwide population-based cohort (Denmark)

Description

Inclusion Criteria:

• persons born in Denmark

Exclusion Criteria:

-

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hospitalization for affective disorder	Danish Psychiatric Central Register	Paticipants will be followed from age 15 until date of first hospitalization for an affective disorder, death, first emigration or end of follow up, an expected average of 12 years
Use of antidepressive medication	The Danish National Prescription Registry	Paticipants will be followed from age 20 until date of second independantly prescription of antidepressive medication, death, first emigration or end of follow up, an expected average of 9 years
Suicide	Danish Register of Causes of Death	Paticipants will be followed from age 18 until date of suicide, other causes of death, first emigration or end of follow up, an expected average of 15 years
Severe cardiovascular disease	The Danish National Patient Register	Paticipants will be followed from age 18 until date of first hospitalization for severe cardiovascular disease, death, first emigration or end of follow up, an expected average of 15 years
Education level	The Register-based System of Demographics and Social Statistics in Denmark	Participants will be followed from age 18 until highest attained educational level, death, first emigration or end of follow up, an average of 20 years
Employment	The Register-based System of Demographics and Social Statistics in Denmark	Employment status at age 30, death, first emigration or end of follow-up, an expected average of 8 years.
Quality of life	SF-36, Self-reported questionnaire	Participants will be answering the questionnaire once (not at a specifik age but between 18-40 years)
Complicated grief	Inventory of Complicated Grief/ Prolonged Grief Disorder (PG-13) and Centrality of Event Scale, Self-reported questionnaire	Participants will be answering the questionnaire once (not at a specifik age but between 18-40 years)
PTSD	Harvard Trauma Questionnaire (HTQ), Self-reported questionnaire	Participants will be answering the questionnaire once (not at a specifik age but between 18-40 years)
Existentiality	Posttraumatic Growth Inventory (PTGI, Self-reported questionnaire	Participants will be answering the questionnaire once (not at a specifik age but between 18-40 years)
Depressive symptoms	The Center for Epidemiological Studies Depression Scale (CES-C)	Participants will be answering the questionnaire once (not at a specifik age but between 18-40 years)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Relationship functioning	Quality of relationship and intimacy, Self-reported questionnaire	Participants will be answering the questionnaire once (not at a specifik age but between 18-40 years)
Support when losing a parent	Self-report items	Participants will be answering the questionnaire once (not at a specifik age but between 18-40 years)
Lifestyle (smoking, alcohol, exercise)	Self-reported questionnaire	Participants will be answering the questionnaire once (not at a specifik age but between 18-40 years)
Coping	Brief cope, Self-reported questionnaire	Participants will be answering the questionnaire once (not at a specifik age but between 18-40 years)

Collaborators and Investigators

• Sponsor: Danish Cancer Society
• Collaborators: Statens Serum Institut; Center for Crisis Psychology; Counselling and Research Center for Grieving Children, Teens and Young Adults; Children´s Welfare
• Investigators: Principal Investigator: Christoffer Johansen, MD, PhD, DSc, Institute of Cancer Epidemiology, Danish Cancer Society; Study Chair: Charlotte W Appel, MSc, Institute of Cancer Epidemiology, Danish Cancer Society; Study Chair: Pernille E Bidstrup, PhD, Institute of Cancer Epidemiology, Danish Cancer Society; Study Chair: Henrik Hjalgrim, PhD, Statens Serum Institut

Study record dates

Study Major Dates

• Study Start: September 1, 2009
• Primary Completion (Actual): November 1, 2012
• Study Completion (Actual): November 1, 2012

Study Registration Dates

• First Submitted: October 11, 2011
• First Submitted That Met QC Criteria: October 14, 2011
• First Posted (Estimate): October 18, 2011

Study Record Updates

• Last Update Posted (Estimate): August 12, 2014
• Last Update Submitted That Met QC Criteria: August 11, 2014
• Last Verified: August 1, 2014

More Information

Terms related to this study

• Keywords: quality of life; cardiovascular diseases; suicide; affective disorders; antidepressive agents; grief; Bereavement; socioeconomic factors; early parental death; depression, depressive symptoms; attempted suicide; Long-term health effects; Socioeconomic outcomes; Psychosocial well-being
• Additional Relevant MeSH Terms: Pathologic Processes; Death; Parental Death
• Other Study ID Numbers: 1-2009; 7134-08 (Other Grant/Funding Number: TrygFonden); 2009-41-3506 (Other Identifier: Danish Data Protection Agency)