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Mental health conditions in bereaved military service widows: A prospective, case‐controlled, and longitudinal study
Author(s) -
Cozza Stephen J.,
Hefner Kathryn R.,
Fisher Joscelyn E.,
Zhou Jing,
Fullerton Carol S.,
Ursano Robert J.,
Shear M. Katherine
Publication year - 2020
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.22971
Subject(s) - mental health , medicine , psychiatry , depression (economics) , mental healthcare , occupational safety and health , health care , suicide prevention , longitudinal study , poison control , gerontology , demography , environmental health , pathology , sociology , economics , macroeconomics , economic growth
Background/Objectives Bereavement is associated with increases in prevalence of mental health conditions and in healthcare utilization. Due to younger age and bereavement by sudden and violent deaths, military widows may be vulnerable to poor outcomes. No systematic research has examined these effects. Method Using outpatient medical records from wives of active‐duty military service members (SMs), we compared the prevalence of mental health conditions and mental healthcare visits among case widows ( n = 1,375) to matched (on age, baseline healthcare utilization, SM deployment, and rank) nonbereaved control military wives ( n = 1,375), from 1 year prior (Yr−1) to 2 years following (Yr+1 and Yr+2) SM death. Prevalence risk ratios and confidence intervals were compared to determine prevalence rates of mental health conditions and outpatient mental healthcare visits over time. Results The prevalence of any mental health condition, as well as a distinct loss‐ and stress‐related mental health conditions, significantly increased from Yr−1 to Yr+1 and Yr+2 for cases as did mental healthcare utilization. Widows with persistent disorders (from Yr+1 to Yr+2) exhibited more mental conditions and mental healthcare utilization than widows whose conditions remitted. Conclusion Bereavement among military widows was associated with a two‐ to fivefold increase in the prevalence of depression, posttraumatic stress disorder, and adjustment disorder postdeath, as well as an increase in mental healthcare utilization. An increase in the prevalence of loss‐ and stress‐related conditions beyond 1 year after death indicates persistent loss‐related morbidity. Findings indicate the need for access to healthcare services that can properly identify and treat these loss‐related conditions.