Parental death is one of the most stressful life events, yet our knowledge of the range and course of psychiatric outcomes in bereaved children is limited. This study examined 140 families in which a parent died suddenly of homicide, suicide, or natural death. Children in these families had a higher incidence of new onset of any psychiatric disorder, depression, or posttraumatic stress disorder (PTSD) compared with nonbereaved controls. The rates of complicated grief were similar among the 3 bereaved groups. The type of death was not predictive of depression within the bereaved group, but the parent having a last confiding conversation with the child before death increased the odds of new-onset depression 4.5-fold. A history of any psychiatric disorder in the offspring increased the likelihood of PTSD nearly 10-fold. This study has important implications for the care of children and families after the loss of a parent.