Background

This study compares a longitudinal population-based sample of spouses bereaved by suicide and those bereaved by other sudden deaths to determine if suicide-bereaved spouses (SBS) experience greater rates of physician-diagnosed mental disorders. Methods: First, married individuals whose spouse died by suicide, sudden natural death (SND) and unintentional injury (UI) were compared to non-bereaved matched cohorts to determine if there were differences in mental disorder rates between bereavement groups and non-bereaved matches. Second, SBS (n = 365), spouses bereaved by SND (n = 1000), and spouses bereaved by UI (n = 270), were compared using inverse probability treatment weighting and generalized estimating equations to calculate relative rates of mental disorders 5 years before/after death. Outcomes: All bereaved cohorts had higher rates of mental disorders compared to non-bereaved cohorts. SBS had the greatest rate of depression post-bereavement (50·96%), followed by UI (38·52%) and SND (33·70%) spouses. When comparing bereavement cohorts, a significant group-by-time interaction (P = 0·047) revealed the rate change for depression was significantly different between suicide and UI-bereaved spouses, with SBS having higher rates of depression before bereavement. SBS had increased rates of any mental disorder both pre (ARR = 1·35, 95% CI = 1·03-1·18, P<·05) and post spousal death (ARR = 1·24, 95% CI = 1·03-1·45, P<·05) when compared to UI spouses signifying pre-existing mental disorders. Post-bereavement, SBS had greater rates of depression only when compared to SND-bereaved spouses (ARR = 1·31, 95% CI = 1·10-1·55, P<·01). Interpretation: SBS have the greatest rates of depression and any mental disorder before the death of their spouse, suggesting suicide bereavement may be unique. Sudden spousal bereavement is a vulnerable time for mental disorders.

中文翻译：

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自杀丧偶：基于人群的纵向队列比较，比较医生诊断的精神障碍和住院自杀未遂。

背景

这项研究比较了自杀造成的配偶和其他突然死亡造成的基于配偶的纵向样本，以确定自杀成亲的配偶（SBS）是否经历了医生诊断出的精神疾病更高的发病率。方法：首先，将其配偶因自杀，突然自然死亡（SND）和意外伤害（UI）死亡的已婚个体与非丧亲配对人群进行比较，以确定丧亲组和非丧亲配对之间的精神障碍发生率是否存在差异。其次，使用逆概率治疗权重和广义估计方程比较SBS（n = 365），SND造成的配偶（n = 1000）和UI造成的配偶（n = 270），以计算5年精神障碍的相对发生率死亡之前/之后。结果：与非丧亲人群相比，所有丧亲人群的精神障碍发生率更高。婚后SBS的抑郁症发生率最高（50·96％），其次是UI（38·52％）和SND（33·70％）配偶。在比较丧亲队列时，有显着的分组时间交互作用（P = 0·047）显示自杀和UI丧亲的配偶的抑郁发生率显着不同，而SBS丧亲前的抑郁发生率更高。SBS在配偶死亡之前（ARR = 1·35，95％CI = 1·03-1·18，P <·05）和配偶后死亡（ARR = 1·24，95％CI = 1）的任何精神障碍发生率均升高·03-1·45，P <·05）与UI配偶相比，表示先前已存在精神障碍。婚后，只有与SND丧偶的配偶相比，SBS的抑郁率更高（ARR = 1·31，95％CI = 1·10-1·55，P <·01）。解释：SBS在配偶去世前的抑郁症和精神障碍患病率最高，这表明自杀丧亲可能是独一无二的。突然丧偶丧亲是精神疾病的脆弱时期。