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Trajectories of antidepressant use before and after union dissolution and re-partnering in later life: a prospective total population register-based cohort study


Background Grey divorce and later remarriage have become increasingly common in high-income countries, but previous evidence on their impacts on mental health is scarce. Even less is known about the effects of non-marital separation and re-partnering in later life.

Methods Using Finnish registry data from 1996 to 2018 on 228 644 individuals aged 50–70 in 2000–2014, trajectories of antidepressant (AD) use 4 years before and 4 years after divorce, non-marital separation, bereavement and subsequent re-partnering were examined using individual fixed-effects (FE) linear probability models.

Results In adjusted FE models, for both genders AD use increased during the 4 years before divorce (men: 5.00 percentage points (95% CI 4.50 to 5.50); women: 6.96 (95% CI 6.34 to 7.59)), non-marital separation (men: 3.20 (95% CI 2.72 to 3.69); women: 5.98 (95% CI 5.30 to 6.66)) and bereavement (men: 4.53 (95% CI 3.97 to 5.09); women: 5.64 (95% CI 5.25 to 6.04)), with the increase accelerating immediately before the event. AD use gradually declined after union dissolution, after which it stabilised on a persistently higher level compared with pre-dissolution. Re-partnering was only associated with a small and transitory reduction in AD use (0.1–1.5 percentage points). The increases in AD use associated with union dissolution were larger in women than in men, whereas the small reductions in AD use associated with re-partnering were particularly short-lived among women.

Conclusions Our results suggest that union dissolution in later life is associated with large and persistent increases in AD use, whereas the reductions associated with re-partnering are limited both in magnitude and duration.


Data availability statement

No data are available. The data that support the findings of this study are available from Statistics Finland and the Social Insurance Institution of Finland. Restrictions apply to the availability of these data, which were used under licence for this study.

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