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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| Veröffentlicht in: | Depression and anxiety 2020-01, Vol.37 (1), p.45-53 |
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| creator | Cozza, Stephen J. Hefner, Kathryn R. Fisher, Joscelyn E. Zhou, Jing Fullerton, Carol S. Ursano, Robert J. Shear, M. Katherine |
| description | 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. |
| doi_str_mv | 10.1002/da.22971 |
| format | Article |
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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.</description><identifier>ISSN: 1091-4269</identifier><identifier>EISSN: 1520-6394</identifier><identifier>DOI: 10.1002/da.22971</identifier><identifier>PMID: 31765052</identifier><language>eng</language><publisher>United States: Hindawi Limited</publisher><subject>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</subject><ispartof>Depression and anxiety, 2020-01, Vol.37 (1), p.45-53</ispartof><rights>Published 2019. This article is a U.S. Government work and is in the public domain in the USA.</rights><rights>2020 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4491-50d5598c938146e428dfc537e828559e7ea21864b9675ff1489bc4590ca10a393</citedby><cites>FETCH-LOGICAL-c4491-50d5598c938146e428dfc537e828559e7ea21864b9675ff1489bc4590ca10a393</cites><orcidid>0000-0002-1861-9173 ; 0000-0002-7682-7528 ; 0000-0001-9597-2758</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fda.22971$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fda.22971$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31765052$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cozza, Stephen J.</creatorcontrib><creatorcontrib>Hefner, Kathryn R.</creatorcontrib><creatorcontrib>Fisher, Joscelyn E.</creatorcontrib><creatorcontrib>Zhou, Jing</creatorcontrib><creatorcontrib>Fullerton, Carol S.</creatorcontrib><creatorcontrib>Ursano, Robert J.</creatorcontrib><creatorcontrib>Shear, M. Katherine</creatorcontrib><title>Mental health conditions in bereaved military service widows: A prospective, case‐controlled, and longitudinal study</title><title>Depression and anxiety</title><addtitle>Depress Anxiety</addtitle><description>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.</description><subject>adjustment disorders</subject><subject>Anxiety disorders</subject><subject>anxiety/anxiety disorders</subject><subject>assessment/diagnosis</subject><subject>depression</subject><subject>grief/bereavement/complicated grief</subject><subject>Longitudinal studies</subject><subject>Medical diagnosis</subject><subject>Medical records</subject><subject>Mental depression</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Military service</subject><subject>Morbidity</subject><subject>Post traumatic stress disorder</subject><subject>posttraumatic stress disorder</subject><subject>Stress</subject><subject>trauma</subject><subject>Widows & widowers</subject><issn>1091-4269</issn><issn>1520-6394</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kc1KAzEURoMoWqvgE0jAjQunJplkJnFX_AfFja6HNLljI-lMncy0dOcj-Iw-iamtCoKrXMjh5Mt3ETqgZEAJYadWDxhTOd1APSoYSbJU8c04E0UTzjK1g3ZDeCGESCXJNtpJaZ4JIlgPze6harXHY9C-HWNTV9a1rq4CdhUeQQN6BhZPnHetbhY4QDNzBvDc2XoezvAQT5s6TMG0bgYn2OgAH2_v0dI2tfdgT7CuLPZ19ezazroqvhTisNhDW6X2AfbXZx89XV0-nt8kdw_Xt-fDu8RwHrMLYoVQ0qhUUp4BZ9KWRqQ5SCbjBeSgGZUZH6ksF2VJuVQjw4UiRlOiU5X20fHKG2O-dhDaYuKCAe91BXUXChabUEKmIovo0R_0pe6amHhJpTyjOWHyV2jiv0MDZTFt3CRWU1BSLHdRWF187SKih2thN5qA_QG_y49AsgLmzsPiX1FxMVwJPwGRyJJ7</recordid><startdate>202001</startdate><enddate>202001</enddate><creator>Cozza, Stephen J.</creator><creator>Hefner, Kathryn R.</creator><creator>Fisher, Joscelyn E.</creator><creator>Zhou, Jing</creator><creator>Fullerton, Carol S.</creator><creator>Ursano, Robert J.</creator><creator>Shear, M. Katherine</creator><general>Hindawi Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1861-9173</orcidid><orcidid>https://orcid.org/0000-0002-7682-7528</orcidid><orcidid>https://orcid.org/0000-0001-9597-2758</orcidid></search><sort><creationdate>202001</creationdate><title>Mental health conditions in bereaved military service widows: A prospective, case‐controlled, and longitudinal study</title><author>Cozza, Stephen J. ; Hefner, Kathryn R. ; Fisher, Joscelyn E. ; Zhou, Jing ; Fullerton, Carol S. ; Ursano, Robert J. ; Shear, M. Katherine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4491-50d5598c938146e428dfc537e828559e7ea21864b9675ff1489bc4590ca10a393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>adjustment disorders</topic><topic>Anxiety disorders</topic><topic>anxiety/anxiety disorders</topic><topic>assessment/diagnosis</topic><topic>depression</topic><topic>grief/bereavement/complicated grief</topic><topic>Longitudinal studies</topic><topic>Medical diagnosis</topic><topic>Medical records</topic><topic>Mental depression</topic><topic>Mental disorders</topic><topic>Mental health</topic><topic>Military service</topic><topic>Morbidity</topic><topic>Post traumatic stress disorder</topic><topic>posttraumatic stress disorder</topic><topic>Stress</topic><topic>trauma</topic><topic>Widows & widowers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cozza, Stephen J.</creatorcontrib><creatorcontrib>Hefner, Kathryn R.</creatorcontrib><creatorcontrib>Fisher, Joscelyn E.</creatorcontrib><creatorcontrib>Zhou, Jing</creatorcontrib><creatorcontrib>Fullerton, Carol S.</creatorcontrib><creatorcontrib>Ursano, Robert J.</creatorcontrib><creatorcontrib>Shear, M. Katherine</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Depression and anxiety</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cozza, Stephen J.</au><au>Hefner, Kathryn R.</au><au>Fisher, Joscelyn E.</au><au>Zhou, Jing</au><au>Fullerton, Carol S.</au><au>Ursano, Robert J.</au><au>Shear, M. Katherine</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mental health conditions in bereaved military service widows: A prospective, case‐controlled, and longitudinal study</atitle><jtitle>Depression and anxiety</jtitle><addtitle>Depress Anxiety</addtitle><date>2020-01</date><risdate>2020</risdate><volume>37</volume><issue>1</issue><spage>45</spage><epage>53</epage><pages>45-53</pages><issn>1091-4269</issn><eissn>1520-6394</eissn><abstract>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.</abstract><cop>United States</cop><pub>Hindawi Limited</pub><pmid>31765052</pmid><doi>10.1002/da.22971</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-1861-9173</orcidid><orcidid>https://orcid.org/0000-0002-7682-7528</orcidid><orcidid>https://orcid.org/0000-0001-9597-2758</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Depression and anxiety, 2020-01, Vol.37 (1), p.45-53 |
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| source | Wiley Online Library Journals Frontfile Complete |
| 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 |
| title | Mental health conditions in bereaved military service widows: A prospective, case‐controlled, and longitudinal study |
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