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Research led by the Karolinska Institutet reports that offspring of parents with mental disorders face increased mortality, with the highest risks for unnatural deaths and when both parents had diagnoses.
Parental mental disorders have been linked to infant mortality and to multiple developmental, mental, and somatic outcomes, while links with long-term offspring mortality remained unclear.
In the study, “Parental Mental Disorders and Offspring Mortality up to Middle Age,” published in JAMA Psychiatry, researchers conducted a nationwide register-based cohort study to investigate associations between parental mental disorders and mortality in offspring up to middle age.
Swedish national registers furnished a cohort of 3,548,788 births from 1973 to 2014, linked to biological parents and followed through December 31, 2023. Participants were aged 9 to 51 years at study end, including 1,818,232 males and 1,730,556 females. Records connected offspring to 1,791,038 mothers and 1,762,659 fathers after excluding 725,654 births due to missing biological father information.
Researchers identified parental mental disorders in the National Patient Register using ICD-8, ICD-9, and ICD-10 codes, grouping diagnoses as alcohol or substance use disorders, psychotic disorders, mood disorders, anxiety or stress-related disorders, eating disorders, personality disorders, and intellectual disability. Outcomes came from the Cause of Death Register and included all-cause, natural, and unnatural deaths, with additional cause groups for cardiovascular disease, cancer, suicide, and unintentional injuries.
Offspring exposed to parental mental disorders showed death rates corresponding to 7.93 per 10,000 person-years, compared to 3.55 per 10,000 person-years among the unexposed.
Adjusted models indicated higher risks in exposed offspring for all-cause mortality with HR 2.13 (95% CI 2.08–2.18), natural causes with HR 1.88 (95% CI 1.83–1.95), and unnatural causes with HR 2.45 (95% CI 2.37–2.54).
Across diagnostic categories, associations were observed with HRs ranging from 1.58 for eating disorders to 2.22 for an intellectual disability.
Dual-parent diagnoses carried even greater relative risks, with HR 3.35 for any death, HR 2.57 for natural death, and HR 4.24 for unnatural death. Peak relative risks appeared when both parents received diagnoses at offspring age 1–2 years, with HR 4.92 for any death, HR 4.50 for natural death, and HR 5.27 for unnatural death.
Elevated risks persisted from infancy through adulthood, with the highest relative risks observed in adulthood.
Findings support providing help for families in which a parent has a mental disorder and call for studies to test whether such support can reduce premature death in affected offspring. Study authors describe public health implications that may grow as participants age, given the high prevalence of exposure and rising absolute mortality risk with age.
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More information:
Hui Wang et al, Parental Mental Disorders and Offspring Mortality up to Middle Age, JAMA Psychiatry (2025). DOI: 10.1001/jamapsychiatry.2025.2572
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Children of parents with mental disorders may face higher risk of early death (2025, October 8)
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