Childhood death of sibling might affect survivor’s lifespan

(Reuters Health) – Death of a sibling in childhood is associated with a greater risk of early death in the surviving brother or sister, researchers say.

“The public should be aware of children’s vulnerability after experiencing sibling loss, especially in the first year and for siblings of same sex or close age,” Dr. Yongfu Yu from Aarhus University Hospital in Denmark told Reuters Health by email. “Tailored social support may help to reduce the level of grief and minimize potential adverse health effects on the bereaved individuals.”

As many as 8 percent of Americans experience the death of a brother or sister in childhood. Loss of a sibling in adulthood has been linked with death of the surviving sibling, but little is known about the association of sibling death in childhood with the subsequent risk of death in the bereaved siblings.

Yu’s team studied data from Danish and Swedish national registries on nearly 56,000 people who, when they were older than 6 months but younger than 18 years, had lost a sibling. For these individuals, the risk of dying over the next 37 years was 71 percent higher than it was for individuals who did not experience the death of a sibling in childhood.

Children who experienced the death of a sibling had an especially increased risk of death from the same cause as their deceased sibling, including a much higher risk of suicide, the research team reported in JAMA Pediatrics.

The strongest associations between childhood sibling death and subsequent risk of dying were in the first year after the sibling had died, and when the bereaved sibling was the same sex as the sibling who died.

The link was also stronger for males than for females and when the siblings were less than two years apart in age.

“As this study was carried out in Denmark and Sweden, the increased mortality risk findings might be less likely caused by the lack of material or health care needs,” Yu speculated. “More death events could reflect genetic susceptibility, direct impacts on bereaved children by psychological stress . . . and indirect impacts through parents’ and other family members’ reactions such as behavioral changes.”

“Further research on social environment and family characteristics might help identify the most vulnerable subgroups of bereaved children, as well as other family members,” Yu said. “The underlying pathways that link this life event and the increased mortality risk needs to be further investigated.”

In an editorial published with the report, Dr. James M. Bolton and colleagues from University of Manitoba in Winnipeg, Manitoba, Canada point out that for adults, research has shown specialized grief psychotherapy to be helpful, but there’s not much data on effective treatments for grieving children and adolescents.

“Efforts to . . . determine effective interventions among youth who experience the death of a sibling are paramount to prevent the excess risk of mental disorders and death seen in this vulnerable group,” they conclude.

SOURCE: JAMA Pediatrics, online April 24, 2017.