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The effects of age are more substantial for nursing home than for hospital care use, and both are larger the older the age at death. Care use will be considerably higher among the non-married. Increasing longevity coupled with a rising trend of dementia is likely to mean a major shift towards higher nursing home care use in the future.

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This study investigated time patterns of post-divorce excess mortality. Using register-based data, we followed 252,641 married Finns from 1990 until subsequent date of divorce and death until 2003. Among men, excess mortality is highest immediately after divorce, followed by a decline over 8 years. Among women, excess mortality shows little variation over time, and is lower than among men at all durations of divorce. Social and economic factors--largely adjustment for post-divorce factors--explain about half of the excess mortality. This suggests that excess mortality is partly mediated through poor social and economic resources. Mortality attributable to accidental, violent, and alcohol-related causes is pronounced shortly after divorce. It shows a strong pattern of reduction over the next 4 years among divorced men, and is high for only 6 months after divorce among divorced women. These findings emphasize the importance of short-term psychological distress, particularly among men.

BackgroundThere is an average negative mental health effect for individuals who experience divorce. Little is known whether the pattern of such divorce effects varies within couples. We study whether the husband and wife experience similar harmful effects of divorce, whether they experience opposite effects, or whether divorce effects are purely individual.MethodsWe use Finnish registry data to compare changes over a period of 5 years in antidepressant use of husbands and wives from 4,558 divorcing couples to 108,637 continuously married pairs aged 40–64, all of whom were healthy at baseline.ResultsIn the period three years before and after divorce antidepressant use increases substantially. However, the likelihood of uptake of antidepressant medication during this process of divorce by one partner appears to be independent of medication uptake in the other partner. In contrast, among continuously married couples there is a clear pattern of convergence: If one partner starts to use antidepressants this increases the likelihood of uptake of antidepressant medication in the other partner.ConclusionsOur findings suggest that divorce effects on antidepressant use are individual and show no pattern of either convergence or divergence at the level of the couple. The increased incidence of antidepressant use associated with divorce occurs in individuals independent of what happens to their ex-partner.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1508-9) contains supplementary material, which is available to authorized users.

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Psychiatric morbidity is a persistent risk factor of divorce. The risk is larger when both spouses experience psychiatric morbidity compared to only one spouse. The findings are consistent with the idea that poor relationship quality and dissatisfaction in couples suffering from mental health problems have long-term consequences for marital stability. Treatment of psychiatric morbidity should not focus only on the individual but on couple-level dynamics.