Widowhood and the risk of psychiatric care, psychotropic medication and all-cause mortality: A cohort study of 658,022 elderly people in Sweden

Abstract

Objectives: To study the effect of widowhood on the risk of psychiatric care, psychotropic medication and mortality, and to study if the effect is modified by educational level.

Method: A nationwide, register-based cohort study. All married or widowed individuals aged 75 and older who were alive and registered in Sweden on 31 December 2004 and still registered on 31 December 2005. A total of 658,022 individuals were included in the study and followed in 2006. Odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated.

Results: Loss of spouse increased the risk of outpatient psychiatric visits, psychotropic medication and all-cause mortality. Prescribed psychotropic medication was more common among those newly bereaved, adjusted OR of 1.46 (95% CI 1.41–1.50), compared to those married. For those widowed for a longer period, the corresponding estimate was 1.12 (95% CI 1.11–1.14). The OR for all-cause mortality was 1.18 (95% CI 1.11–1.26). The analyses also indicated different effects on inpatient care depending on educational level.

Conclusion: Loss of spouse increases the risk of people getting psychiatric care, both for severe and minor psychiatric conditions. The effect seems to differ depending on educational level. Further studies are needed to disentangle the mechanism behind the effects of each measurement of psychiatric conditions and how these are affected by educational level.

Keywords:

• psychiatry
• educational attainment
• psychotropic medication
• mortality
• elderly
• marital status