Mental health conditions in bereaved military service widows: A prospective, case‐controlled, and longitudinal study

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 effec...

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Bibliographic Details
Published in:Depression and anxiety 2020-01, Vol.37 (1), p.45-53
Main Authors: Cozza, Stephen J., Hefner, Kathryn R., Fisher, Joscelyn E., Zhou, Jing, Fullerton, Carol S., Ursano, Robert J., Shear, M. Katherine
Format: Article
Language:English
Subjects:
adjustment disorders
Anxiety disorders
anxiety/anxiety disorders
assessment/diagnosis
depression
grief/bereavement/complicated grief
Longitudinal studies
Medical diagnosis
Medical records
Mental depression
Mental disorders
Mental health
Military service
Morbidity
Post traumatic stress disorder
posttraumatic stress disorder
Stress
trauma
Widows & widowers
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Summary: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.
ISSN:1091-4269
1520-6394
DOI:10.1002/da.22971