title: Gender and the relationship between marital status and first onset of mood, anxiety and substance use disorders.
abstract: BACKGROUND
  Prior research on whether marriage is equally beneficial to the mental health of men and women is inconsistent due to methodological variation. This study addresses some prior methodological limitations and investigates gender differences in the association of first marriage and being previously married, with subsequent first onset of a range of mental disorders.
  
  
  METHODS
  Cross-sectional household surveys in 15 countries from the WHO World Mental Health survey initiative (n=34493), with structured diagnostic assessment of mental disorders using the Composite International Diagnostic Interview 3.0. Discrete-time survival analyses assessed the interaction of gender and marital status in the association with first onset of mood, anxiety and substance use disorders.
  
  
  RESULTS
  Marriage (versus never married) was associated with reduced risk of first onset of most mental disorders in both genders; but for substance use disorders this reduced risk was stronger among women, and for depression and panic disorder it was confined to men. Being previously married (versus stably married) was associated with increased risk of all disorders in both genders; but for substance use disorders, this increased risk was stronger among women and for depression it was stronger among men.
  
  
  CONCLUSIONS
  Marriage was associated with reduced risk of the first onset of most mental disorders in both men and women but there were gender differences in the associations between marital status and onset of depressive and substance use disorders. These differences may be related to gender differences in the experience of multiple role demands within marriage, especially those concerning parenting.
authors: Department of Psychological Medicine, University of Otago, Wellington, New Zealand. kate.scott@otago.ac.nz
authors: K M
authors: KM
authors: Scott
authors: J E
authors: JE
authors: Wells
authors: M
authors: M
authors: Angermeyer
authors: T S
authors: TS
authors: Brugha
authors: E
authors: E
authors: Bromet
authors: K
authors: K
authors: Demyttenaere
authors: G
authors: G
authors: de Girolamo
authors: O
authors: O
authors: Gureje
authors: J M
authors: JM
authors: Haro
authors: R
authors: R
authors: Jin
authors: A Nasser
authors: AN
authors: Karam
authors: V
authors: V
authors: Kovess
authors: C
authors: C
authors: Lara
authors: D
authors: D
authors: Levinson
authors: J
authors: J
authors: Ormel
authors: J
authors: J
authors: Posada-Villa
authors: N
authors: N
authors: Sampson
authors: T
authors: T
authors: Takeshima
authors: M
authors: M
authors: Zhang
authors: R C
authors: RC
authors: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology*; D015999:Multivariate Analysis; D012306:Risk; D017678:Sex Distribution; D019966:Substance-Related Disorders / Q000453:epidemiology*; D016019:Survival Analysis