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Mortality in offspring of mothers with psychotic disorder

Published online by Cambridge University Press:  30 November 2007

J. Suvisaari ,
L. Häkkinen ,
J. Haukka  and
J. Lönnqvist
J. Suvisaari*
Affiliation:
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland Department of Social Psychiatry, Tampere School of Public Health, University of Tampere, Finland
L. Häkkinen
Affiliation:
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
J. Haukka
Affiliation:
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland Department of Social Psychiatry, Tampere School of Public Health, University of Tampere, Finland
J. Lönnqvist
Affiliation:
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland Department of Psychiatry, University of Helsinki; Helsinki University Central Hospital, Helsinki, Finland
*
*Address for correspondence: J. Suvisaari, M.D., Ph.D., National Public Health Institute, Department of Mental Health and Alcohol Research, Mannerheimintie 166, FIN-00300 Helsinki, Finland. (Email: [email protected])
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Abstract

Background

Previous studies suggest that offspring of mothers with psychotic disorders have an almost two-fold higher mortality risk from birth until early adulthood. We investigated predictors of mortality from late adolescence until middle age in offspring of mothers with psychotic disorders.

Method

The Helsinki High-Risk Study follows up offspring (n=337) of women treated for schizophrenia spectrum disorders in mental hospitals in Helsinki before 1975. Factors related to mortality up to 2005 among offspring of these mothers was investigated with a survival model. Hazard rate ratios (HRR) were calculated using sex, diagnosis of psychotic disorder, childhood socio-economic status, maternal diagnosis, and maternal suicide attempts and aggressive symptoms as explanatory variables. The effect of family was investigated by including a frailty term in the model. We also compared mortality between the high-risk group and the Finnish general population.

Results

Within the high-risk group, females had lower all-cause mortality (HRR 0.43, p=0.05) and mortality from unnatural causes (HRR 0.24, p=0.03) than males. Having themselves been diagnosed with a psychotic disorder was associated with higher mortality from unnatural causes (HRR 4.76, p=0.01), while maternal suicide attempts were associated with higher suicide mortality (HRR 8.64, p=0.03). Mortality in the high-risk group was over two-fold higher (HRR 2.44, p<0.0001) than in the general population, and remained significantly higher when high-risk offspring who later developed psychotic disorders were excluded from the study sample (HRR 2.30, p<0.0001).

Conclusions

Offspring of mothers with psychotic disorder are at increased risk of several adverse outcomes, including premature death.

Keywords

High-risk studymortalityoffspringpsychosisschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 8 , August 2008 , pp. 1203 - 1210
Copyright
Copyright © 2007 Cambridge University Press

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