Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, MD; Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD.
Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD.
J Acad Consult Liaison Psychiatry. 2022 Sep-Oct;63(5):434-444. doi: 10.1016/j.jaclp.2022.02.007. Epub 2022 Mar 5.
Bereavement has been associated with increases in immune/inflammatory and neuroendocrine reactions, cardiovascular events, nonspecific physical symptoms, mental conditions, and health care utilization. However, little is known about bereavement effects in younger samples, multiple health effects within samples, or prebereavement to postbereavement health changes.
To determine the effect of bereavement on the prevalence of medical conditions and utilization of health care.
This study examined the prevalence of 15 medical conditions and health care utilization before and in the first and second years after bereavement in a population of 1375 U.S. military widows and compared them to those of 1375 nonbereaved U.S. military control wives.
Compared with controls, widows showed greater increases in prebereavement levels of prevalence of ill-defined conditions and mental health conditions in years 1 and 2 following bereavement. Health care utilization also increased for widows compared with controls. Utilization was highest for widows with comorbid ill-defined conditions and mental health conditions.
The increased prevalence of both ill-defined conditions and mental health diagnoses following bereavement and the resultant need for increased health care utilization in this help-seeking sample suggest a need for proactive health monitoring of all military widows to identify and treat mental health conditions, as well as recognize manifestations of physical symptoms, in those who may not seek treatment.
丧亲会导致免疫/炎症和神经内分泌反应、心血管事件、非特异性躯体症状、精神状况以及医疗保健利用增加。然而，对于年轻人群体中的丧亲影响、样本中的多种健康影响，或丧亲前至丧亲后健康变化，我们知之甚少。
确定丧亲对疾病患病率和医疗保健利用的影响。
本研究在 1375 名美国军队寡妇人群中，检查了丧亲前和丧亲后 1 年和 2 年内 15 种疾病的患病率和医疗保健利用情况，并将其与 1375 名无丧亲经历的美国军队对照妻子进行了比较。
与对照组相比，寡妇在丧亲后 1 年和 2 年，未明确定义的疾病和精神健康状况的患病率预丧亲水平上升幅度更大。与对照组相比，寡妇的医疗保健利用也有所增加。患有未明确定义的疾病和精神健康疾病的寡妇的利用率最高。
丧亲后未明确定义的疾病和精神健康诊断的患病率增加，以及在这个寻求帮助的样本中，医疗保健利用率增加，这表明需要积极主动地监测所有军队寡妇的健康状况，以识别和治疗精神健康状况，以及认识到那些可能不寻求治疗的人的躯体症状表现。
