Suicidal behavior and parental psychopathology in South Africa: Results from the cross- sectional South African Stress and Health Survey

Background: Prior studies have demonstrated a link between suicidal behavior and parental psychopathology; however, it remains unclear what aspects of suicidal behavior are predicted by specific parental mental disorders. This study set out to investigate the association between parental psychopathology and offspring suicidal behavior in a South African general population sample. Method: Parental psychopathology and suicidal behavior in offspring were assessed using structured interviews among 4,315 respondents from across South Africa. The WHO CIDI was used to collect data on suicidality, while the Family History Research Diagnostic Criteria Interview was used to assess parental psychopathology. Bivariate and multivariate survival models tested the associations between the type and number parental mental disorders (including suicide) and lifetime suicidal behavior in the offspring. Associations between a range of parental disorders and the onset of subsequent suicidal behavior (suicide ideation, plans, and attempts) among offspring were tested. Results: The presence of parental psychopathology significantly increased the odds of suicidal behavior among offspring. More specifically, parental panic disorder was associated with respondent suicide ideation, while parental panic disorder, generalized anxiety disorder and suicide were significantly associated with suicide attempts. Among those with suicide ideation, none of the tested forms of parental psychopathology was associated with having suicide plans or attempts. There was a dose-response relationship between the number of parental disorders and odds of suicidal ideation. Suicidal Behavior and Parental Psychopathology in South Africa 3 Conclusions: Parental psychopathology increases the odds of suicidal behavior in the South African context, replicating results found in other regions. Specific parental disorders predicted the onset and persistence of suicide ideation or attempts in their offspring. Further research into these associations is recommended in order to determine the mechanisms through which parent psychopathology increases the odds of suicidal behavior among offspring.