Annette Erlangsen1, Bo Runeson2, James M Bolton3, Holly C Wilcox4, Julie L Forman5, Jesper Krogh6, M Katherine Shear7, Merete Nordentoft8, Yeates Conwell9. 1. Danish Research Institute for Suicide Prevention, Mental Health Centre, Copenhagen, Denmark2Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland3iPSYCH, Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark4Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark. 2. Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. 3. Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada. 4. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland7Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland. 5. Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. 6. Danish Research Institute for Suicide Prevention, Mental Health Centre, Copenhagen, Denmark. 7. Columbia School of Social Work, Columbia University College of Physicians and Surgeons, New York, New York. 8. Danish Research Institute for Suicide Prevention, Mental Health Centre, Copenhagen, Denmark3iPSYCH, Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark. 9. Center for the Study and Prevention of Suicide, Department of Psychiatry, and Office for Aging, University of Rochester Medical Center, Rochester, New York.
Abstract
Importance: Bereavement after spousal suicide has been linked to mental disorders; however, a comprehensive assessment of the effect of spousal suicide is needed. Objective: To determine whether bereavement after spousal suicide was linked to an excessive risk of mental, physical, and social health outcomes when compared with the general population and spouses bereaved by other manners. Design, Setting, and Participants: This nationwide, register-based cohort study conducted in Denmark of 6.7 million individuals aged 18 years and older from 1980 to 2014 covered more than 136 million person-years and compared people bereaved by spousal suicide with the general population and people bereaved by other manners of death. Incidence rate ratios were calculated using Poisson regressions while adjusting for sociodemographic characteristics and the presence of mental and physical disorders. Main Outcomes and Measures: Mental disorders (any disorder, mood, posttraumatic stress disorder, anxiety, alcohol use disorders, drug use disorders, and self-harm); physical disorders (cancers, diabetes, sleep disorder, cardiovascular diseases, chronic lower respiratory tract diseases, liver cirrhosis, and spinal disc herniation); causes of mortality (all-cause, natural, unintentional, suicide, and homicide); social health outcomes; and health care use. Results: The total study population included 3 491 939 men, 4814 of whom were bereaved by spousal suicide, and 3 514 959 women, 10 793 of whom were bereaved by spousal suicide. Spouses bereaved by a partner's suicide had higher risks of developing mental disorders within 5 years of the loss (men: incidence rate ratio, 1.8; 95% CI, 1.6-2.0; women: incidence rate ratio, 1.7; 95% CI, 1.6-1.8) than the general population. Elevated risks for developing physical disorders, such as cirrhosis and sleep disorders, were also noted as well as the use of more municipal support, sick leave benefits, and disability pension funds than the general population. Compared with spouses bereaved by other manners of death, those bereaved by suicide had higher risks for developing mental disorders (men: incidence rate ratio, 1.7; 95% CI, 1.5-1.9; women: incidence rate ratio, 2.0; 95% CI, 1.9-2.2), suicidal behaviors, mortality, and municipal support. Additionally, a higher level of mental health care use was noted. Conclusions and Relevance: Exposure to suicide is stressful and affects the bereaved spouse on a broad range of outcomes. The excess risks of mental, physical, and social health outcomes highlight a need for more support directed toward spouses bereaved by suicide.
Importance: Bereavement after spousal suicide has been linked to mental disorders; however, a comprehensive assessment of the effect of spousal suicide is needed. Objective: To determine whether bereavement after spousal suicide was linked to an excessive risk of mental, physical, and social health outcomes when compared with the general population and spouses bereaved by other manners. Design, Setting, and Participants: This nationwide, register-based cohort study conducted in Denmark of 6.7 million individuals aged 18 years and older from 1980 to 2014 covered more than 136 million person-years and compared people bereaved by spousal suicide with the general population and people bereaved by other manners of death. Incidence rate ratios were calculated using Poisson regressions while adjusting for sociodemographic characteristics and the presence of mental and physical disorders. Main Outcomes and Measures: Mental disorders (any disorder, mood, posttraumatic stress disorder, anxiety, alcohol use disorders, drug use disorders, and self-harm); physical disorders (cancers, diabetes, sleep disorder, cardiovascular diseases, chronic lower respiratory tract diseases, liver cirrhosis, and spinal disc herniation); causes of mortality (all-cause, natural, unintentional, suicide, and homicide); social health outcomes; and health care use. Results: The total study population included 3 491 939 men, 4814 of whom were bereaved by spousal suicide, and 3 514 959 women, 10 793 of whom were bereaved by spousal suicide. Spouses bereaved by a partner's suicide had higher risks of developing mental disorders within 5 years of the loss (men: incidence rate ratio, 1.8; 95% CI, 1.6-2.0; women: incidence rate ratio, 1.7; 95% CI, 1.6-1.8) than the general population. Elevated risks for developing physical disorders, such as cirrhosis and sleep disorders, were also noted as well as the use of more municipal support, sick leave benefits, and disability pension funds than the general population. Compared with spouses bereaved by other manners of death, those bereaved by suicide had higher risks for developing mental disorders (men: incidence rate ratio, 1.7; 95% CI, 1.5-1.9; women: incidence rate ratio, 2.0; 95% CI, 1.9-2.2), suicidal behaviors, mortality, and municipal support. Additionally, a higher level of mental health care use was noted. Conclusions and Relevance: Exposure to suicide is stressful and affects the bereaved spouse on a broad range of outcomes. The excess risks of mental, physical, and social health outcomes highlight a need for more support directed toward spouses bereaved by suicide.
Authors: Naomi M Simon; Katherine M Shear; Elizabeth H Thompson; Alyson K Zalta; Carol Perlman; Charles F Reynolds; Ellen Frank; Nadine M Melhem; Russell Silowash Journal: Compr Psychiatry Date: 2007-07-05 Impact factor: 3.735
Authors: Libby Sallnow; Richard Smith; Sam H Ahmedzai; Afsan Bhadelia; Charlotte Chamberlain; Yali Cong; Brett Doble; Luckson Dullie; Robin Durie; Eric A Finkelstein; Sam Guglani; Melanie Hodson; Bettina S Husebø; Allan Kellehear; Celia Kitzinger; Felicia Marie Knaul; Scott A Murray; Julia Neuberger; Seamus O'Mahony; M R Rajagopal; Sarah Russell; Eriko Sase; Katherine E Sleeman; Sheldon Solomon; Ros Taylor; Mpho Tutu van Furth; Katrina Wyatt Journal: Lancet Date: 2022-02-01 Impact factor: 79.321
Authors: Alexandra Pitman; Tanisha De Souza; Adelia Khrisna Putri; Fiona Stevenson; Michael King; David Osborn; Nicola Morant Journal: Int J Environ Res Public Health Date: 2018-04-03 Impact factor: 3.390
Authors: Alexandra Pitman; Adelia Khrisna Putri; Tanisha De Souza; Fiona Stevenson; Michael King; David Osborn; Nicola Morant Journal: Int J Environ Res Public Health Date: 2018-03-31 Impact factor: 3.390