sorrow or general sadness) as an outcome ( Segal et al., 1995 Segal and Ream, 1998 Rosendahl and Björklund, 2013). With regard to psychiatric reactions to a co-twin death, only a handful of descriptive studies with small sample sizes have been conducted, mainly using self-reported measures of grief (i.e. Nevertheless, scientific studies on this topic are relatively rare. Consequently, losing a co-twin by death may be a particularly devastating life stressor with considerable health implications for the surviving twins ( Segal and Bouchard, 1993). Moreover, the 100% genetic share between monozygotic twins may contribute to even closer emotional ties between them than dizygotic twins ( Neyer, 2002 Cassell, 2011 Fortuna et al., 2010). The results revealed that, although loss of a sibling led to less obvious short-term rate elevations (compared to the loss of a child or spouse), sibling bereavement was associated with the greatest long-term risk elevations of the studied adverse psychiatric consequences.īy virtue of being born at the same time, both monozygotic and dizygotic twins tend to have more in common (e.g., early life experiences) and report stronger emotional bond than other sibling-pairs ( Bank and Kahn, 1997 Neyer, 2002). A recent Danish population-based study compared the relative weight of the different types of bereavement (loss of child, spouse, sibling, and parents) with regard to the subsequent risk of suicide, deliberate self-harm and psychiatric illness ( Guldin et al., 2017). Nevertheless, although the sibling tie represents one of the most enduring kin relations across the life course ( Bedford, 2012), sibling loss has received relatively scant attention in the scientific literature. An excess risk of morbidity and mortality was observed among individuals who experienced the loss of a spouse ( Prior et al., 2018 Brenn and Ytterstad, 2016), parent ( Bylund Grenklo et al., 2013 Rostila et al., 2016), or child ( Hendrickson, 2009 Li et al., 2003). The death of a close relative has been linked to a variety of adverse health consequences among bereaved family members. As dizygotic twins share equal genetic relatedness to the deceased twin as their full siblings, this pattern suggests that beyond the contribution of genetic factors, shared early life experiences and attachment contribute to the risk of psychiatric disorders among surviving twins after co-twin loss. Similarly, compared to non-twin full siblings, the relative risks were significantly increased after loss of monozygotic co-twin (2.45-fold), and loss of a dizygotic co-twin (1.29-fold), with higher HR observed with greater age gaps between twins and non-twin siblings. Compared to the non-bereaved twins, exposed twins were at increased risk of receiving a first diagnosis of psychiatric disorders (hazard ratio = 1.65, 95% confidence interval1.48–1.83), particularly during the first month after loss. We identified all Swedish-born twins who lost a co-twin by death between 19 (n = 4,528), their 4939 non-twin full siblings, together with 22,640 age- and sex-matched non-bereaved twins. ![]() ![]() ![]() Losing a co-twin by death is a severely stressful event yet with unknown impact on the surviving twin’s risk of psychiatric disorders.
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