Children of Parents With Serious Mental Illness: With Whom Do They Grow Up? A Prospective, Population-Based Study.

Objective: To provide an overview of living arrangements during childhood for children of parents with schizophrenia, bipolar disorder, and depression.

Method: Information was obtained from Danish registers on children's addresses and used to calculate the proportion living in different household living arrangements. The study was conducted as a prospective, register-based cohort study covering all children in the entire Danish population born after 1982 (N = 1,823,625) and their parents with a diagnosis of schizophrenia, bipolar disorder, depression, or none of these disorders. Regression analyses were performed assessing the risk of dissolution of the conjugal family.

Results: Children's living arrangements were characterized by fewer nuclear families and more single-parent-headed households when parents had serious mental illness (SMI). From birth, 15% to 20% of children lived with a single mother with SMI. Conjugal families were dissolved at higher rates if a parent had SMI, especially if the mother (incidence rate ratio 2.98; 95% CI 2.80-3.17) or the father (incidence rate ratio 2.60; 95% CI 2.47-2.74) had schizophrenia. Risks for family dissolution varied greatly with parents' socioeconomic position in all diagnostic groups.

Conclusion: Parents' SMI affects children's family living arrangements because fewer children live with both parents and more children live with a single parent or are separated from both parents. Family cohesion seems especially difficult to maintain when parents have schizophrenia.