Physical illness and changes in spousal mental health: a register-based study on Finnish couples aged 30–70

Background Spousal caregiving is linked to increased symptoms of poor mental health among older people. Less is known about the effects of physical health conditions with different progression and level of impairment on spousal mental health among younger people. Methods Using Finnish total population register data, we identified 106 673 partnered individuals aged 30–70, newly diagnosed in 2000–2015 with progressive conditions with increasing impairment (Parkinson’s disease, multiple sclerosis, dementia), acute conditions with sudden impairment (stroke) and acute conditions without cognitive impairment (myocardial infarction, prostate cancer, female breast cancer), and employed event–study difference-in-difference models to assess short-term and long-term effects on spouses’ 6-month probability of psychotropic medication purchases (Anatomical Therapeutic Chemical (ATC) codes N05B, N05C and N06A) by type of health condition. Results Incident stroke had a sudden effect on spousal psychotropic medication purchase probability (2.1 percentage points increase among female and 1.4 percentage points increase among male spouses). Effect size attenuated thereafter, although more slowly among female spouses, yet remained over 1 percentage point in the long term. Smaller (about 0.7 percentage points among female and 0.5 percentage points among male spouses), but also persistent, effect was observed following the diagnosis of acute conditions without cognitive impairments. For progressive conditions, little changes occurred around the time of diagnosis. Conclusions Acute onset of physical illness may have sudden and persistent adverse impact on spousal mental health in midlife even when prognosis is good and expectations for spousal care are likely to be limited.