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Psychotropic medication among children who experience parental death to cancer

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Abstract

The psychological consequences of losing a parent to cancer are unclear. We investigated whether experiencing parental death to cancer before 18 years of age increases the risk of psychotropic medication. We used register data of all children born in Denmark between 1 January 1987 and 31 December 2016 (N = 1,488,846). We assessed rate ratios (RRs) with 95% confidence intervals (CIs) for first redeemed prescription of antidepressants, anxiolytics and hypnotics according to parental death status using Poisson multi-state models. We further examined whether the associations differed according to the gender of the deceased parent, child’s age at the time of death or the parental length of illness. Cancer-bereaved children had a significantly increased risk of first prescription of psychotropic medication (rate ratio, RR 1.22, 95% confidence interval, CI 1.10–1.34 for males; RR 1.18, 95% CI 1.09–1.28 for females). Associations were strongest if the parent had the same sex as the child and if the parent died within one year of diagnosis. The risk was highest during the first six months after the loss (RR 2.35, 95% confidence interval, CI 1.48–3.73 for males; RR 1.81, 95% CI 1.17–2.80 for females). Children who lose a parent to cancer, particularly in cases when the disease progressed quickly, may need extra psychological support, especially during the first six months after the death.

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Data availability

This study is based on nationwide registry data available through Statistics Denmark’s Division of Research Services (https://www.dst.dk/en/TilSalg/Forskningsservice). Access to registry data is only possible when the approval and permission from the relevant data regulation agencies have been obtained.

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Acknowledgements

We thank Anja Krøyer for her invaluable help in the data management of this study.

Funding

This work was supported by the Danish Cancer Society—Psychosocial Fund (Grant number R119-A7589-15-S35).

Author information

Authors and Affiliations

  1. Psychological Aspects of Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark

    Beverley Lim Høeg, Linda Banko, Charlotte Weiling Appel & Pernille Envold Bidstrup

  2. Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark

    Jane Christensen & Kirsten Frederiksen

  3. Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark

    Charlotte Weiling Appel

  4. Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark

    Susanne Oksbjerg Dalton

  5. Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark

    Susanne Oksbjerg Dalton

  6. Center for Crisis Psychology, University of Bergen, Bergen, Norway

    Atle Dyregrov & Martin Lytje

  7. Research Unit for General Practice, Aarhus University, Aarhus, Denmark

    Mai-Britt Guldin

  8. National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark

    Sanne Ellegaard Jørgensen

  9. Department of Patient Support and Community Activities, Danish Cancer Society, Copenhagen, Denmark

    Martin Lytje & Per Bøge

  10. Department of Psychology, University of Copenhagen, Copenhagen, Denmark

    Pernille Envold Bidstrup

Authors
  1. Beverley Lim Høeg
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  2. Jane Christensen
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  3. Linda Banko
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  11. Per Bøge
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  12. Pernille Envold Bidstrup
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Contributions

BLH contributed to the design of the study, acquisition of data, analysis and interpretation of data and drafted the initial manuscript. JC managed the data and carried out the data analyses. LB contributed to the conception and design of the study, the analysis and interpretation of the data. KF contributed to the design of the study and supervised the data analyses. CWA, AD, MBG, SJ, ML and PB contributed to the analysis and interpretation of the data. SOD contributed to the supervision of the study, analysis and interpretation of the data. PED contributed to the conception and design of the study, acquisition of data, supervision of the study, the analysis and interpretation of the data. All authors reviewed and revised the manuscript, and approved the final manuscript as submitted.

Corresponding author

Correspondence to Beverley Lim Høeg.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethics approval and consent to participate

Since only anonymized registry data was used, no ethical approval or informed consent is required under Danish law. This study is registered at the Danish Cancer Society Research Center’s internal records (2019-DCRC-0124) under the European Union’s General Data Protection Regulation.

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Not applicable.

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Høeg, B.L., Christensen, J., Banko, L. et al. Psychotropic medication among children who experience parental death to cancer. Eur Child Adolesc Psychiatry 32, 155–165 (2023). https://doi.org/10.1007/s00787-021-01846-y

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