Spousal depression, anxiety, and suicide after myocardial infarction.
OBJECTIVE
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.


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.


CONCLUSIONS
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.
Duke Clinical Research Institute, Duke University Medical Center, 2400 Pratt Street, Room 7461, Terrace Level, Durham, NC 27705, USA. emil.fosbol@duke.edu
Emil L
EL
Fosbøl
Eric D
ED
Peterson
Peter
P
Weeke
Tracy Y
TY
Wang
Robin
R
Mathews
Lars
L
Kober
Laine
L
Thomas
Gunnar H
GH
Gislason
Christian
C
Torp-Pedersen
D017677:Age Distribution; D000368:Aged; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy / Q000209:etiology*; D001569:Benzodiazepines / Q000627:therapeutic use; D016022:Case-Control Studies; D016757:Death, Sudden, Cardiac; D003718:Denmark; D003866:Depressive Disorder / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology*; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D018454:Spouses / Q000523:psychology*; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D001569:Benzodiazepines