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Spousal depression, anxiety, and suicide after myocardial infarction

Emil L. Fosbøl , Eric D. Peterson , Peter Weeke , Tracy Y. Wang , Robin Mathews , Lars Kober , Laine Thomas , Gunnar H. Gislason , Christian Torp-Pedersen
DOI: http://dx.doi.org/10.1093/eurheartj/ehs242 First published online: 22 August 2012

Abstract

Aims Death of a spouse from acute myocardial infarction (AMI) presents hardship, yet few studies have investigated the psychological consequences of fatal and non-fatal AMI on spouses.

Methods and results Several Danish national registries were linked to identify individuals whose spouses had a fatal or non-fatal AMI. Married patients with fatal or non-fatal AMI (1997–2008) were matched with their counterparts dying or hospitalized with a non-AMI cause; incident use of antidepressants and benzodiazepines, incident depression care, and suicides were compared pre- and post-event using Poisson models. Overall, 16 506 spouses of individuals dying of AMI were matched with 49 518 spouses of individuals dying of a non-AMI cause. Similarly, 44 566 spouses of individuals with a non-fatal AMI were matched with 131 563 spouses of individuals with a non-fatal, non-AMI hospitalization. Those whose spouse died of AMI (compared with a non-AMI cause) had increased antidepressant and benzodiazepine use [peak incidence rate ratio (IRR) 5.7 vs. 3.3, and 46.4 vs. 13.0, respectively; P< 0.001]. Those whose spouse had a non-fatal AMI (compared with a non-AMI hospitalization) had increased risk for antidepressant and benzodiazepine initiation (IRR 1.5 vs. 1.1, and 6.7 vs. 1.3, respectively, P< 0.001). Spouses of fatal AMI patients also had an increased risk of depression and suicide. Male individuals whose spouse had a fatal or non-fatal AMI had a relatively higher increased risk of depression than female individuals.

Conclusion Spouses of those who experience AMIs—both fatal and non-fatal—are at elevated risk for psychological consequences; therefore, the care needs of AMI patients and their spouses need to be considered.

  • Acute myocardial infarction
  • Spousal psychological consequences
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