Surviving Spouses in Unhappy Marriages Have Fewer Health Problems than Survivors from Happy Marriages

The surviving spouse in an unhappy marriage is likely to have fewer health problems than a spouse who loses his or her partner in a happy marriage, a Yale study shows.

“Freud said that ambivalent and conflicted relationships would predispose the survivor to pathological grief,” said Holly Prigerson, assistant professor of psychiatry at Yale School of Medicine. “But we found losing a partner in a harmonious marriage puts you at greater risk of health problems. Your health care costs are lower if you are widowed in a discordant marriage.”

Prigerson, whose study is published in the June issue of The Gerontologist, said the finding is significant because there are 13.5 million widowed persons in the United States and 10.5 million are 65 or older. Health care spending for Americans 65 and older is four times higher than for persons under 65, and widowhood may be a contributing factor, she said.

The researchers interviewed 694 people who were part of a longitudinal study on successful aging and who remained married between the initial survey and the follow up. Of that number, 61 had become widowed.

The investigators then looked at the health care costs of the married persons when compared to widowed persons and then looked at the health costs of widows and widowers from happy and unhappy marriages.

The marriages were characterized based on questions posed to the couples before widowhood - questions such as degree of marital satisfaction, love and affection; frequency of thoughts of separation and divorce; frequency of disagreements and upset feelings about the marriage; the extent to which they would feel “lost” without their spouses, and frequency of being pushed, slapped or hit by a spouse.

The researchers found annual health care costs were $2,384 for widowed persons compared with $1,498 for those who were married. Health care costs for the surviving partners in happy marriages were $2,766 compared with $2,100 for surviving partners in unhappy marriages.

Prigerson said the loss for the survivor in a happy marriage is often so profound it can be defined as “traumatic grief syndrome” - normal grieving to an extreme, such as unusual separation distress, excessive yearning and pining, and extreme emptiness and loneliness.

Earlier studies also indicate that people who suffer traumatic grief are more prone to cancer, heart problems, increased alcohol and tobacco use, weight gain, sleep disturbances, and suicidal thoughts.

“Doctors should realize that older widowed people are at increased risk, specifically those who get along well and those who might depend too much on their spouses,” Prigerson said. “Many widowed persons in the study needed mental health care, but few received it.”

The other investigators on the study were Paul Maciejewski, associate research scientist and biostatistician in the Department of Internal Medicine, and Robert Rosenheck, M.D., professor of psychiatry.

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