Losing a spouse to suicide increased the risk for a wide range of health and psychosocial conditions, according to a recent study. Rates of mental disorders, certain medical conditions, and several social factors were greater for those surviving a spousal suicide than for those in the general population or who lost a spouse to other causes.
“Using nationwide data, exposure to spousal suicide was linked to higher risks for developing mental disorders, suicidal behavior, specific physical disorders, any cause of mortality, suicide, dying by homicide, adverse social events, and mental health care use when compared with the general population,” reported Annette Erlangsen, PhD, from the Mental Health Centre Copenhagen in Denmark, and colleagues in JAMA Psychiatry. Rates of mental disorders, mental healthcare usage, mortality, and certain social outcomes were also greater in those whose spouses died by suicide compared with in those whose spouses died from other causes, they wrote.
The researchers analyzed data from a nationwide register on 7 million people, aged 18 years and older, between 1980 and 2014. They compared the incidence of mental disorders, physical disorders, mortality causes, social health outcomes, and healthcare use among those who lost their spouses to suicide, those grieving other types of spousal deaths, and the general population.
The physical disorders they looked at included cancer, diabetes, sleep disorders, cardiovascular disease, chronic lower respiratory tract disease, liver cirrhosis, and spinal disc herniation. Mental disorders referred to any diagnosed disorder, including posttraumatic stress disorder, mood or anxiety disorders, alcohol or drug use disorders, and self-harm.
Among almost 3.5 million men, 4814 lost a spouse to suicide and were 1.8 times more likely than the general population to develop a mental disorder in the 5 years after the loss. Similarly, the 10,793 women who lost a spouse to suicide had a rate of mental disorders 1.7 times greater in the 5 years after the death than that of the general population.
The increased risk of developing a mental disorder, particularly mood disorders and PTSD, was also greater for these individuals than the risk for those whose spouses died in another way. Mental disorders occurred 1.7 times more often for men widowed as a result of suicide, and twice as often for women widowed as a result of suicide, compared with those whose widowhood was unrelated to suicide. The survivor of a spousal suicide also had higher rates of suicidal behaviors, mortality, and use of mental healthcare and municipal support compared with others whose spouses died.
Those whose spouse died by suicide also had a higher incidence of specific physical problems, including cancer, cirrhosis, sleep disorders, and chronic lower respiratory tract diseases. The authors suggested these might have resulted from “unhealthy coping styles, such as alcohol use disorder, or a weakening of the immune system, both related to psychosocial stress.”
Mortality and suicide rates were also higher among those widowed because of suicide compared with both the general population and those with other spousal losses. A potential reason is neglect for the bereaved individual’s own health, the authors suggest. Further, use of sick leave benefits, disability pensions, and municipal support were all greater among those who lost spouses to suicide compared with the general population, but they were lower compared with those whose spouses died other ways. The older age of those whose spouses died in other ways may have played a role in this finding, the authors note.
The researchers noted that spousal bereavement has also been associated with complicated grief, which various short-term interventions have helped.
“Women bereaved by suicide had less contact with their general practitioners than the general population, and men bereaved by suicide had less primary care contact than those bereaved by other manners of death,” the authors wrote. “This is concerning, as primary care could provide an access point for support and suggests the need for more aggressive outreach following bereavement by suicide.”
Erlangsen A, Runeson B, Bolton, et al. Association between spousal suicide and mental, physical, and social health outcomes: a longitudinal and nationwide register-based study. JAMA Psychiatry doi: 10.1001/jamapsychiatry.2017.0226