HOME HELP FEEDBACK SUBSCRIPTIONS ALL ISSUES SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Zivin, K. Articles by Christakis, N. A. Search for Related Content PubMed PubMed Citation Articles by Zivin, K. Articles by Christakis, N. A.

The Emotional Toll of Spousal Morbidity and Mortality

From Veterans Affairs, Health Services Research and Development, Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI (KZ); the Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI (KZ); and the Department of Health Care Policy, Harvard Medical School, Boston, MA (NAC).

Objective: Spouse caregivers have an increased risk of mental and physical illness during caregiving and widowhood. The authors sought to evaluate whether partners of an ill spouse have a higher likelihood of developing mental health or substance abuse (MHSA) disorders than partners who have healthy spouses, accounting for both spousal illness and death.

Methods: The authors used Medicare claims from 1993–2001 for 474,228 married couples. The authors used Cox models to determine the effect of spouse illness on partner MHSA diagnosis, controlling for demographic and clinical characteristics.

Results: A wife’s hospitalization increased the husband’s risk of MHSA diagnosis by 1.29 (95% confidence interval [CI]: 1.28–1.29) and his risk of depression by 1.49 (95% CI: 1.48–1.51). A husband’s hospitalization increased the risk of a wife’s MHSA diagnosis by 1.33 (95% CI: 1.32–1.33) and her risk of depression by 1.41 (95% CI: 1.39–1.42). A wife’s death increased the risk of the husband’s MHSA diagnosis by 1.12 (95% CI: 1.11–1.13) and increased his risk of depression by 1.49 (95% CI: 1.46–1.51). A husband’s death increased the risk of the wife’s MHSA diagnosis by 1.14 (95% CI: 1.14–1.15) and increased her risk of depression by 1.41 (95% CI: 1.39–1.42).

Conclusion: Spouse hospitalizations and spouse death independently increase the risk for partner MHSA and depression diagnoses. These findings can identify which individuals are at greatest risk for emotional distress and should be targeted for interventions to relieve caregiver burden that can arise separately and additively from both spousal illness and death.

Key Words: caregiving • bereavement • depression • mental health and substance abuse • Medicare