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We identified all Swedish-born twins who lost a co-twin by death between 1973 and 2013 (n = 4,528), their 4939 non-twin full siblings, together with 22,640 age- and sex-matched non-bereaved twins. 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\u20131.83), particularly during the first month after 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. 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.<\/jats:p>","DOI":"10.7554\/elife.56860","type":"journal-article","created":{"date-parts":[[2020,7,13]],"date-time":"2020-07-13T20:01:16Z","timestamp":1594670476000},"update-policy":"https:\/\/doi.org\/10.7554\/elife.56860","source":"Crossref","is-referenced-by-count":14,"title":["Risk of psychiatric disorders among the surviving twins after a co-twin loss"],"prefix":"10.7554","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3845-8079","authenticated-orcid":true,"given":"Huan","family":"Song","sequence":"first","affiliation":[{"name":"West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China"},{"name":"Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjav\u00edk, Iceland"},{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"Larsson","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"},{"name":"School of Medical Sciences, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang","family":"Fang","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catarina","family":"Almqvist","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"},{"name":"Astrid Lindgren Children\u2019s Hospital, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy L","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Psychology, University of Southern California, Los Angeles, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrik KE","family":"Magnusson","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5382-946X","authenticated-orcid":true,"given":"Unnur A","family":"Valdimarsd\u00f3ttir","sequence":"additional","affiliation":[{"name":"Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjav\u00edk, Iceland"},{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4374","published-online":{"date-parts":[[2020,7,14]]},"reference":[{"key":"bib1","volume-title":"The Sibling Bond","author":"Bank","year":"1997"},{"key":"bib2","doi-asserted-by":"crossref","first-page":"125","DOI":"10.5040\/9798400661266.ch-006","volume-title":"Handbook of Families and Aging","author":"Bedford","year":"2012"},{"key":"bib3","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.ypmed.2016.06.019","article-title":"Increased risk of death immediately after losing a spouse: cause-specific mortality following widowhood in Norway","volume":"89","author":"Brenn","year":"2016","journal-title":"Preventive Medicine"},{"key":"bib4","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1001\/jamapediatrics.2013.430","article-title":"Self-injury in teenagers who lost a parent to Cancer: a nationwide, population-based, long-term follow-up","volume":"167","author":"Bylund Grenklo","year":"2013","journal-title":"JAMA Pediatrics"},{"key":"bib5","article-title":"Examining the twin bond: a look at the psychological development of twins and the differences in individuality and identity","author":"Cassell","year":"2011","unstructured":"Cassell S. 2011. 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