TY - JOUR

T1 - Serious mental illness and disrupted caregiving for children

T2 - a nationwide, register-based cohort study

AU - Ranning, Anne

AU - Munk Laursen, Thomas

AU - Thorup, Anne

AU - Hjorthøj, Carsten

AU - Nordentoft, Merete

N1 - © Copyright 2015 Physicians Postgraduate Press, Inc.

PY - 2015/8

Y1 - 2015/8

N2 - OBJECTIVE: To study how often severe psychiatric disorders adversely affect a person's ability to be a parent, indicated by the child being placed in out-of-home care.METHOD: This study was conducted in 2013 as a prospective, register-based cohort study covering all first-born singletons in the entire Danish population born after 1982 (N = 782,092) and their parents. Rates of out-of-home placement of children with parents diagnosed with schizophrenia, bipolar disorder, or unipolar depression, according to the criteria of the International Statistical Classification of Diseases and Related Health Problems, 8th revision (ICD-8) and ICD, 10th revision (ICD-10), were analyzed. The rates were compared with those of children with parents from the general population.RESULTS: A parental diagnosis of schizophrenia was the most prominent risk factor for children placed outside the home, with an accumulated risk for being placed in care at some point during childhood-40% for children with mothers with schizophrenia and 20% for children with fathers with schizophrenia. Children of mothers (incidence rate ratio [IRR] = 23.75; 95% CI, 20.94-26.93) and fathers (IRR = 7.85; 95% CI, 6.67-9.25) with a diagnosis of schizophrenia had the overall highest IRRs of placement in care. Having a mother with bipolar disorder was the second most prominent risk factor (IRR = 5.76; 95% CI, 4.50-7.36), followed by a maternal diagnosis of unipolar depression (IRR = 4.28; 95% CI, 3.73-4.90). Risks were especially high during the child's first year of life, indicating a critical period, especially for children with mothers with schizophrenia (IRR = 80.19; 95% CI, 68.09-94.43). Risks varied greatly with parents' socioeconomic factors in all diagnostic groups.CONCLUSIONS: Parental schizophrenia is a strong risk factor for placement of children in out-of-home care.

AB - OBJECTIVE: To study how often severe psychiatric disorders adversely affect a person's ability to be a parent, indicated by the child being placed in out-of-home care.METHOD: This study was conducted in 2013 as a prospective, register-based cohort study covering all first-born singletons in the entire Danish population born after 1982 (N = 782,092) and their parents. Rates of out-of-home placement of children with parents diagnosed with schizophrenia, bipolar disorder, or unipolar depression, according to the criteria of the International Statistical Classification of Diseases and Related Health Problems, 8th revision (ICD-8) and ICD, 10th revision (ICD-10), were analyzed. The rates were compared with those of children with parents from the general population.RESULTS: A parental diagnosis of schizophrenia was the most prominent risk factor for children placed outside the home, with an accumulated risk for being placed in care at some point during childhood-40% for children with mothers with schizophrenia and 20% for children with fathers with schizophrenia. Children of mothers (incidence rate ratio [IRR] = 23.75; 95% CI, 20.94-26.93) and fathers (IRR = 7.85; 95% CI, 6.67-9.25) with a diagnosis of schizophrenia had the overall highest IRRs of placement in care. Having a mother with bipolar disorder was the second most prominent risk factor (IRR = 5.76; 95% CI, 4.50-7.36), followed by a maternal diagnosis of unipolar depression (IRR = 4.28; 95% CI, 3.73-4.90). Risks were especially high during the child's first year of life, indicating a critical period, especially for children with mothers with schizophrenia (IRR = 80.19; 95% CI, 68.09-94.43). Risks varied greatly with parents' socioeconomic factors in all diagnostic groups.CONCLUSIONS: Parental schizophrenia is a strong risk factor for placement of children in out-of-home care.

KW - Adolescent

KW - Adult

KW - Bipolar Disorder

KW - Child

KW - Child Care

KW - Child of Impaired Parents

KW - Child, Preschool

KW - Cohort Studies

KW - Denmark

KW - Depressive Disorder

KW - Fathers

KW - Female

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Male

KW - Mothers

KW - Registries

KW - Schizophrenia

U2 - 10.4088/JCP.13m08931

DO - 10.4088/JCP.13m08931

M3 - Journal article

C2 - 26335086

VL - 76

SP - e1006-14

JO - Journal of Clinical Psychiatry

JF - Journal of Clinical Psychiatry

SN - 0160-6689

IS - 8

ER -