Mental health conditions in bereaved military service widows: A prospective, case-controlled, and longitudinal study

Depress Anxiety. 2020 Jan;37(1):45-53. doi: 10.1002/da.22971. Epub 2019 Nov 25.


Background/objectives: Bereavement is associated with increases in prevalence of mental health conditions and in healthcare utilization. Due to younger age and bereavement by sudden and violent deaths, military widows may be vulnerable to poor outcomes. No systematic research has examined these effects.

Method: Using outpatient medical records from wives of active-duty military service members (SMs), we compared the prevalence of mental health conditions and mental healthcare visits among case widows (n = 1,375) to matched (on age, baseline healthcare utilization, SM deployment, and rank) nonbereaved control military wives (n = 1,375), from 1 year prior (Yr-1) to 2 years following (Yr+1 and Yr+2) SM death. Prevalence risk ratios and confidence intervals were compared to determine prevalence rates of mental health conditions and outpatient mental healthcare visits over time.

Results: The prevalence of any mental health condition, as well as a distinct loss- and stress-related mental health conditions, significantly increased from Yr-1 to Yr+1 and Yr+2 for cases as did mental healthcare utilization. Widows with persistent disorders (from Yr+1 to Yr+2) exhibited more mental conditions and mental healthcare utilization than widows whose conditions remitted.

Conclusion: Bereavement among military widows was associated with a two- to fivefold increase in the prevalence of depression, posttraumatic stress disorder, and adjustment disorder postdeath, as well as an increase in mental healthcare utilization. An increase in the prevalence of loss- and stress-related conditions beyond 1 year after death indicates persistent loss-related morbidity. Findings indicate the need for access to healthcare services that can properly identify and treat these loss-related conditions.

Keywords: adjustment disorders; anxiety/anxiety disorders; assessment/diagnosis; depression; grief/bereavement/complicated grief; posttraumatic stress disorder; trauma.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adjustment Disorders / epidemiology
  • Adult
  • Bereavement*
  • Case-Control Studies
  • Depression / epidemiology
  • Depression / psychology
  • Female
  • Grief*
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Health / statistics & numerical data*
  • Military Personnel*
  • Prevalence
  • Prospective Studies
  • Spouses / psychology*
  • Spouses / statistics & numerical data*
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology