Declining Medication Use After Parental Loss May Not Mean Recovery

Losing a parent as a teenager or young adult can have lasting effects on mental health for many years. While some young people develop mental health difficulties after the loss, others may already be struggling before the death of the parent. Understanding how medication use changes over time may help identify those who need continued support.

In a study recently published in the scientific journal Social Psychiatry and Psychiatric Epidemiology, the research team from Stockholm University examined patterns of psychotropic medication use among over 140,000 people who lost a parent between the ages of 10 and 29. Using Swedish national register data, the researchers tracked dispensed medication from two years before the death to four years afterwards.

The study identified four distinct patterns of medication use: consistently low or no use, increasing use after the loss, declining use after the loss, and persistently high use. All three groups with elevated medication use had a higher risk of suicide mortality than the group with consistently low or no use. Their risk was approximately three times as high, even after the researchers accounted for factors including socioeconomic circumstances, previous psychiatric hospitalisation and characteristics of the parental death.

“What stood out to me was that young people whose medication use declined still faced an elevated risk of suicide. Fewer prescriptions do not necessarily mean recovery, and we should not overlook the mental health needs of young people who have lost a parent, even years after the loss,” says Daniel N. Tollosa, researcher at the Department of Public Health Sciences at Stockholm University.

Different Medication Pattern – Comparable Suicide Risk

One of the study's most notable findings was that young people whose medication use declined after parental loss had a suicide mortality risk comparable to that of those whose use increased or remained persistently high.
There may be several explanations for declining medication use. For some, it may reflect recovery or a transition to other forms of treatment. For others, it may not indicate that their mental health has improved.

“A reduction in medication use may be a positive development for some young people, but we cannot assume that it always reflects improved mental health. Our findings show why medication patterns need to be considered alongside other indicators of mental health,” Tollosa says.

The research team also found that a history of psychiatric hospitalisation was strongly associated with belonging to the groups with elevated medication use. Lower socioeconomic status was another factor associated with these patterns, highlighting the importance of considering young people's wider circumstances when assessing their mental health needs.

The Importance of Continued Support

The findings of this study highlight the value of following mental health needs over time after parental bereavement, rather than relying on medication use as the sole indicator of recovery. For healthcare professionals, this means considering changes in medication alongside a person's mental health history, current circumstances and need for further care. Accessible bereavement support and coordination between healthcare, schools and social services may also help young people receive appropriate support as their needs change.

Importantly, the study does not show that psychotropic medications increase suicide risk. Instead, patterns of medication use may serve as indicators of underlying vulnerability and help identify groups who could benefit from closer monitoring.

“Losing a parent affects young people differently, and their need for support may continue long after the loss. Our findings highlight the importance of continued attention to mental health, even when medication use decreases,” Tollosa concludes

Håkan Soold

Facts

The study Psychotropic medication trajectories around parental bereavement and their association with suicide mortality among adolescents and young adults, a Swedish nationwide cohort study was recently published in the scientific journal Social Psychiatry and Psychiatric Epidemiology.

In addition to Daniel N. Tollosa, the following researchers contributed to the study: Can Liu, Alessandra Grotta, Ayako Hiyoshi, Lisa Berg, Sandra Rogne and Professor Mikael Rostila from the Department of Public Health Sciences at Stockholm University.