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Mental Health, Ill-Defined Conditions, and Health Care Utilization Following Bereavement: A Prospective Case-Control
Joscelyn E Fisher1, David S Krantz2, Christin M Ogle1
1Center 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.
Background:
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.
Objective:
To determine the effect of bereavement on the prevalence of medical conditions and utilization of health care.
Methods:
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.
Results:
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.
Conclusions:
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.
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