Abstract：
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.
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.
摘要：
背景：灰色离婚和后来的再婚在高收入国家变得越来越普遍，但是以前关于它们对心理健康影响的证据很少。人们对非婚分居和晚年生活中重新伴侣的影响知之甚少。
方法：使用1996年至2018年的芬兰注册数据，在2000年至2014年期间，年龄在50-70岁之间的228644名个体中，抗抑郁药（AD）的使用轨迹在离婚前4年和离婚后4年使用，非婚分居,使用个体固定效应（FE）线性概率模型检查了丧亲和随后的重新伴侣关系。
结果：在调整后的FE模型中，在离婚前的4年内，两种性别的AD使用率均增加（男性：5.00个百分点（95％CI4.50至5.50）；女性：6.96（95％CI6.34至7.59）），非婚分居（男性：3.20（95％CI2.72至3.69）；女性：5.98（95％CI5.30至6.66））和丧亲（男性：4.53（95％CI3.97至5.09）；女性：5.64（95％CI5.25至6.04）），事件发生前立即加速增加。联合解散后，AD使用逐渐下降，之后,与溶解前相比,其稳定在持续较高的水平。重新合作仅与AD使用的少量和短暂减少（0.1-1.5个百分点）相关。女性与工会解散相关的AD使用增加大于男性，而与重新合作相关的AD使用的小幅减少在女性中尤为短暂.
结论：我们的结果表明，晚年的工会溶解与AD使用的大量持续增加有关，而与重新合作相关的减少在幅度和持续时间上都是有限的。
方法：使用1996年至2018年的芬兰注册数据，在2000年至2014年期间，年龄在50-70岁之间的228644名个体中，抗抑郁药（AD）的使用轨迹在离婚前4年和离婚后4年使用，非婚分居,使用个体固定效应（FE）线性概率模型检查了丧亲和随后的重新伴侣关系。
结果：在调整后的FE模型中，在离婚前的4年内，两种性别的AD使用率均增加（男性：5.00个百分点（95％CI4.50至5.50）；女性：6.96（95％CI6.34至7.59）），非婚分居（男性：3.20（95％CI2.72至3.69）；女性：5.98（95％CI5.30至6.66））和丧亲（男性：4.53（95％CI3.97至5.09）；女性：5.64（95％CI5.25至6.04）），事件发生前立即加速增加。联合解散后，AD使用逐渐下降，之后,与溶解前相比,其稳定在持续较高的水平。重新合作仅与AD使用的少量和短暂减少（0.1-1.5个百分点）相关。女性与工会解散相关的AD使用增加大于男性，而与重新合作相关的AD使用的小幅减少在女性中尤为短暂.
结论：我们的结果表明，晚年的工会溶解与AD使用的大量持续增加有关，而与重新合作相关的减少在幅度和持续时间上都是有限的。
