Early Parental Death and Risk of Psychosis in Offspring: A Six-Country Case-Control Study

Supriya Misra*, Bizu Gelaye, Karestan C. Koenen, David R. Williams, Christina P. C. Borba, Diego Quattrone, Marta Di Forti, Caterina La Cascia, Daniele La Barbera, Ilaria Tarricone, Domenico Berardi, Andrei Szoke, Celso Arango, Andrea Tortelli, Lieuwe de Haan, Eva Velthorst, Julio Bobes, Miguel Bernardo, Julio Sanjuan, Jose Luis SantosManuel Arrojo, Cristina Marta Del-Ben, Paulo Rossi Menezes, Jean-Paul Selten, Peter B. Jones, James B. Kirkbride, Bart P. E. Rutten, Jim van Os, Robin M. Murray, Charlotte Gayer-Anderson, Craig Morgan, EU-GEI WP2 Group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Evidence for early parental death as a risk factor for psychosis in offspring is inconclusive. We analyzed data from a six-country, case-control study to examine the associations of early parental death, type of death (maternal, paternal, both), and child's age at death with psychosis, both overall and by ethnic group. In fully adjusted multivariable mixed-effects logistic regression models, experiencing early parental death was associated with 1.54-fold greater odds of psychosis (95% confidence interval (CI): 1.23, 1.92). Experiencing maternal death had 2.27-fold greater odds (95% CI: 1.18, 4.37), paternal death had 1.14-fold greater odds (95% CI: 0.79, 1.64), and both deaths had 4.42-fold greater odds (95% CI: 2.57, 7.60) of psychosis compared with no early parental death. Experiencing parental death between 11 and 16 years of age had 2.03-fold greater odds of psychosis than experiencing it before five years of age (95% CI: 1.02, 4.04). In stratified analyses, experiencing the death of both parents had 9.22-fold greater odds of psychosis among minority ethnic groups (95% CI: 2.02-28.02) and no elevated odds among the ethnic majority (odds ratio (OR): 0.96; 95% CI: 0.10-8.97), which could be due in part to the higher prevalence of early parental death among minority ethnic groups but should be interpreted cautiously given the wide confidence intervals.

Original languageEnglish
Article number1081
Number of pages13
JournalJournal of Clinical Medicine
Issue number7
Publication statusPublished - Jul 2019


  • childhood adversities
  • early parental death
  • early bereavement
  • ethnic minorities
  • psychosis
  • schizophrenia
  • population-based
  • case-control
  • multi-country
  • RACE


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