The spouses of people who suffer sudden heart attacks are more likely to need care for depression and have a higher risk of suicide in subsequent years, a study finds.
In the first such study of its kind, researchers in Denmark and the U.S. looked into the effect a patient's heart attack can have on the partner.
The study, published in the European Heart Journal, found that even if the heart attack victim survives, the partner suffers more psychological effects than those whose spouses are killed by other conditions.
Researchers made use of the National Civil Status Registry, which shows whether people are married or not, to compare 16,506 spouses of people who died from an AMI (acute myocardial infarction) between 1997 and 2008, with 49,518 spouses of people who died from other causes.
They also compared 44,566 spouses of patients who survived an AMI with 131,563 spouses of people who were admitted to hospital with a non-fatal condition.
People were analysed for their use of antidepressants and anti-anxiety drugs before, and up to a year after the event, and the researchers also analysed the rates of depression and suicide.
"We found that more than three times the number of people whose spouses died from an AMI were using antidepressants in the year after the event, compared with the year before," said chief author Dr Emil Fosbol.
"In addition, nearly 50 times as many spouses used a benzodiazepine [anti-anxiety drugs] after the event compared to before. For people whose spouse had died from a non-AMI cause, we saw a much higher rate of medication use for other causes and they had an approximately 50 percent higher likelihood of claiming a prescription for these drugs.
"Those whose spouse survived an AMI had a 17 percent higher use of antidepressants after the event, whereas spouses of patients surviving some other, non-AMI related condition had an unchanged use of antidepressants after the event compared to before."
The researchers say the sudden nature of a heart attack is the determining factor.
Fosbol adds: "If your partner dies suddenly from a heart attack, you have no time to prepare psycholgically for the death, whereas if someone is ill with, for example, cancer, there is more time to grow used to the idea. The larger psychological impact of a sudden loss is similar to post-traumatic stress disorder."
Fosbol believes the study findings have serious public health implications, due to the fact that some 7 million people worldwide suffer an AMI yearly, with around 16 percent dying within a month.
He said: "This could mean that around 11,000 people would be more likely to start antidepressants after a spouse's non-fatal AMI, and 35,000 after their spouse died from an AMI.
"Moreover, although suicide rates were low, we could expect approximately 1,400 people to take their own life in the year following a spouse's death from a heart attack."
The authors warn that there are currently no mechanisms in place to identify spouses at risk and to institute preventative strategies such as screening for depression and grief counselling.
Fosbol concludes: "I think it would be worth conducting a study of targeting intervention to prevent depression for the spouse.
"I believe that treatment of an acute event also should include screening the spouse for possible psychological effects and a plan should be in place for how to take care of this, if indeed the spouse is severely affected."