Parental Death and Psychiatric Disorders Among Individuals with and Without Experience of Out-of-Home Care: A Swedish Nationwide Cohort Study

ICON member Sandra Rogne participated in a Swedish nationwide cohort study examining whether parental death during childhood influences the association between out-of-home care and psychiatric disorders in adulthood.

About the study

Children and adolescents who experience out-of-home care (OHC) face an increased risk of psychiatric disorders later in life. Parental death during childhood is also associated with poorer mental health, and occurs more frequently among children with experience of OHC. However, less is known about whether parental death adds to the psychiatric risk associated with OHC and whether this differs depending on the timing and duration of placement.

The study included 944,138 individuals born in Sweden between 1972 and 1981, of whom 23,106 (2.5%) experienced OHC between ages 0 and 19. Information on OHC, parental death and family characteristics was obtained from linked national registers, while psychiatric disorders were identified through the National Patient Register. Participants were followed for psychiatric disorders from ages 20 to 47, and analyses considered different patterns of OHC according to the timing and duration of placement.

Individuals with experience of OHC had an increased risk of psychiatric disorders throughout adulthood, with the highest risks among those first placed during adolescence. Parental death was also associated with increased psychiatric risk. However, the association between parental death and psychiatric disorders was attenuated in several OHC groups compared with individuals without experience of care, suggesting that parental death may add relatively limited additional risk within an already highly vulnerable population.

The findings highlight the accumulation of disadvantages among individuals with experience of OHC and point to the importance of interventions that address multiple risks across different developmental periods rather than focusing on individual adverse experiences in isolation.

Highlights

“Individuals with experience of out-of-home care had an increased risk of psychiatric disorders in adulthood, with the highest risks observed among those first placed during their teenage years”.

“Parental death appeared to add limited additional psychiatric risk among individuals with experience of out-of-home care, highlighting the high level of accumulated disadvantage already present in this population”.

Publication details

Seker, S., Brännström, L., Forsman, H., & Rogne, S. (2026). Parental death and psychiatric disorders among individuals with and without experience of out-of-home care: A Swedish nationwide cohort study. International Journal of Environmental Research and Public Health, 23(6), 732.

Read more: https://doi.org/10.3390/ijerph23060732

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