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Mental health, ill-defined conditions, and healthcare utilization following bereavement: A prospective case-control study

APA Citation:

Fisher, J. E., Krantz, D. S., Ogle, C. M., Zhou, J., Zuleta, R. F., Strickman, A. K., Fullerton, C. S., Ursano, R. J., & Cozza, S. J. (2022). Mental health, ill-defined conditions, and health care utilization following bereavement: A prospective case-control study. Journal of the Academy of Consultation-Liaison Psychiatry, 63(5), 434-444. https://doi.org/10.1016/j.jaclp.2022.02.007

Abstract Created by REACH:

This longitudinal study compared the physical and mental health conditions and health care utilization (i.e., military and nonmilitary facilities) among military widows (n = 1,375) and nonbereaved military wives (n = 1,375). Physical health conditions (e.g., infections, metabolic disease, unexplained physical symptoms), mental health conditions (e.g., anxiety disorders), the number of physical health visits, and mental health visits were examined 1 year prior to the loss of a spouse and 1 and 2 years following bereavement. Compared to nonbereaved wives, widows generally demonstrated more unexplained physical health symptoms and mental health conditions over time.


Mental health
Physical health

Branch of Service:

Air Force
Marine Corps
Multiple branches

Military Affiliation:

Active Duty

Subject Affiliation:

Spouse of service member or veteran


Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


Longitudinal Study
Quantitative Study
Secondary Analysis


Fisher, Joscelyn E., Krantz, David S., Ogle, Christin M., Zhou, Jing, Zuleta, Rafael F., Strickman, Amy K., Fullerton, Carol S., Ursano, Robert J., Cozza, Stephen J.


Background Bereavement has been associated with increases in immune/inflammatory and neuroendocrine reactions, cardiovascular events, non-specific physical symptoms, mental conditions, and healthcare utilization. However, little is known about bereavement effects in younger samples, multiple health effects within samples, or health changes from pre- to post-bereavement. Purpose To determine the effect of bereavement on the prevalence of medical conditions and utilization of healthcare. Procedures This study examined the prevalence of fifteen medical conditions and healthcare utilization before, and in the first and second years following bereavement in a population of 1375 U.S. military widows and compared them to 1375 non-bereaved U.S. military control wives. Main Findings Compared to controls, widows showed greater increases from pre-bereavement levels in prevalence of ill-defined conditions and in mental health conditions in years 1 and 2 following bereavement. Healthcare utilization also increased for widows compared to controls. Utilization was highest for widows with comorbid ill-defined conditions and mental health conditions. Principal Conclusions The increased prevalence of both ill-defined conditions and mental health diagnoses following bereavement and the resultant need for increased healthcare utilization in this help-seeking sample suggests a need for proactive health monitoring of all military widows to identify and treat mental health conditions, as well as recognize manifestations of physical symptoms, in those who may not seek treatment.

Publisher/Sponsoring Organization:


Publication Type:

REACH Publication

Author Affiliation:

Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, JEF
Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., JEF
Department of Medical and Clinical Psychology, Uniformed Services University, JEF


mental health, bereavement, healthcare utilization, ill-defined conditions

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REACH Publication Type:

Research Summary

REACH Newsletter:

  July 2022

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