Background

Sibling loss has received scant attention in the bereavement literature. A previous study suggested an overall increased risk of mortality in siblings bereaved during childhood. However, the underlying disease pattern behind increased mortality is unclear. We studied the influence of sibling loss during childhood on in and outpatient care with an underlying psychiatric diagnosis in adulthood.

Methods

A national cohort born in Sweden in 1973-1982 (N = 717,723) was followed prospectively in the Cause of Death Register until 2013, i.e. from ages 18 years to 31-40 years of age. Cox proportional hazards models were used to analyse the association between sibling loss during childhood and psychiatric in- and outpatient care during follow-up.

Results

After adjustment for socio-demographic confounders and parental psychosocial covariates, HR for psychiatric inpatient-and outpatient care in bereaved siblings versus non- bereaved siblings was fairly small and non-significant in women. Bereaved men had increased HR for both psychiatric inpatient- (HR 1.17, 95% CI 1.00-1.36) and outpatient care (HR 1.21, 95% CI 1.10-1.33). Risks were however more pronounced when exposed to loss of a sibling in adolescence (i.e. in the ages 12-18 years) in both men and women.

Conclusions

The death of a sibling in childhood was associated with slightly increased risk of psychiatric in and out-patient care in surviving siblings in adulthood in men but not in women. Individuals experiencing the loss of a sibling in childhood may need particular attention from health care services.