Birth order and suicide in adulthood: Evidence from Swedish population data.

[Argirios Argiriou]

Rostila M et al.
Am J Epidemiol 2014 Jun 15; 179:1450.

Birth order and suicide in adulthood: Evidence from Swedish population data.

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Joel Yager, MD reviewing Rostila M et al. Am J Epidemiol 2014 Jun 15.
Results from a large Swedish study


Studies on the psychological effects of birth order have yielded an array of sometimes conflicting findings. Some research has suggested that higher birth order may be linked to greater risk for depression, anxiety, and even suicide. Using data from nationwide Swedish registries, investigators examined relationships between birth order and suicide within individual families in adults born from 1932 through 1980; follow-up continued from 1980 through 2002.

The registries accounted for 10,656 suicides. Subanalyses examining adult variables were performed for those born in 1932–1955. Models variously adjusted for age, marital status, socioeconomic status, socioeconomic order within one's sibship, and maternal age at birth (factors that were, at most, only modestly associated with suicide). In fully adjusted models, second-born children were 17% more likely to die by suicide than first-born children; the risks for third-born and fourth- or higher-born children were 43% and 63%, respectively. Sib order was also weakly associated with death by external causes (e.g., accidents), but not with cardiovascular, cerebrovascular, or cancer-related deaths.

COMMENT

These findings extend the findings from a smaller previous study from Norway. They also are consistent with the hypotheses that later-born children receive less attention from parents and attach more weakly to them, are more subject to bullying by older sibs, and have greater vulnerability to depression and impulsivity. Although much more fine-grained analysis is required to explicate the mechanisms for these links, clinicians might want to add birth order and its impacts to their consideration of suicide risk.

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