Death of a child is one of the most distressing events that can happen to a parent. Pediatric Bipolar Disorder (PBD) is associated with increased risk of suicide and a significant disruption in Family quality of life (QoL). It is possible that the threat of suicide leads to impaired family interactions, and thus could mediate the relationship between suicide and Family QoL. The goal of the present study is:
To examine family functioning (FF) in PBD comparing three groups: Suicide Attempters (SA, n=18) to Suicide Ideation (SI, n=50) and Non Suicidal PBD (NS, n=39), and to evaluate the extent to which functioning mediates between suicidality and Family QoL.
Primary caregivers completed the KINDLR and FAD scales to assess QoL and FF on 107 PBD (ages 8-18). Suicidality was evaluated using a semi-structured interview of both caregiver and youth. Diagnoses were blind to the scales.
Families of SA had significantly worse functioning than NS group on the Problem Solving (PS), General Functioning (GF) and the Total FAD (T-FAD) Scale, p < .05. The relationship between SA and Family QoL was partially mediated by PS, GF, T-FAD Scale, ps <.05. SI and SA continued to have a direct (non-causal) effect on family QoL.
Results are consistent with a model where youth SA stress parents and disrupt FF, resulting in lower QoL. Longitudinal data are needed to clarify the direction of effect, as poor FF could lead to increased risk of suicide. Present findings suggest that both directions of effect deserve consideration.