title: A multinational study of mental disorders, marriage, and divorce.
abstract: OBJECTIVE
  Estimate predictive associations of mental disorders with marriage and divorce in a cross-national sample.
  
  
  METHODS
  Population surveys of mental disorders included assessment of age at first marriage in 19 countries (n = 46,128) and age at first divorce in a subset of 12 countries (n = 30,729). Associations between mental disorders and subsequent marriage and divorce were estimated in discrete time survival models.
  
  
  RESULTS
  Fourteen of 18 premarital mental disorders are associated with lower likelihood of ever marrying (odds ratios ranging from 0.6 to 0.9), but these associations vary across ages of marriage. Associations between premarital mental disorders and marriage are generally null for early marriage (age 17 or younger), but negative associations come to predominate at later ages. All 18 mental disorders are positively associated with divorce (odds ratios ranging from 1.2 to 1.8). Three disorders, specific phobia, major depression, and alcohol abuse, are associated with the largest population attributable risk proportions for both marriage and divorce.
  
  
  CONCLUSIONS
  This evidence adds to research demonstrating adverse effects of mental disorders on life course altering events across a diverse range of socioeconomic and cultural settings. These effects should be included in considerations of public health investments in preventing and treating mental disorders.
authors.affiliation: Department of Internal Medicine, University of California, USA.
authors.forename: J
authors.initials: J
authors.lastname: Breslau
authors.forename: E
authors.initials: E
authors.lastname: Miller
authors.forename: R
authors.initials: R
authors.lastname: Jin
authors.forename: N A
authors.initials: NA
authors.lastname: Sampson
authors.forename: J
authors.initials: J
authors.lastname: Alonso
authors.forename: L H
authors.initials: LH
authors.lastname: Andrade
authors.forename: E J
authors.initials: EJ
authors.lastname: Bromet
authors.forename: G
authors.initials: G
authors.lastname: de Girolamo
authors.forename: K
authors.initials: K
authors.lastname: Demyttenaere
authors.forename: J
authors.initials: J
authors.lastname: Fayyad
authors.forename: A
authors.initials: A
authors.lastname: Fukao
authors.forename: M
authors.initials: M
authors.lastname: Gălăon
authors.forename: O
authors.initials: O
authors.lastname: Gureje
authors.forename: Y
authors.initials: Y
authors.lastname: He
authors.forename: H R
authors.initials: HR
authors.lastname: Hinkov
authors.forename: C
authors.initials: C
authors.lastname: Hu
authors.forename: V
authors.initials: V
authors.lastname: Kovess-Masfety
authors.forename: H
authors.initials: H
authors.lastname: Matschinger
authors.forename: M E
authors.initials: ME
authors.lastname: Medina-Mora
authors.forename: J
authors.initials: J
authors.lastname: Ormel
authors.forename: J
authors.initials: J
authors.lastname: Posada-Villa
authors.forename: R
authors.initials: R
authors.lastname: Sagar
authors.forename: K M
authors.initials: KM
authors.lastname: Scott
authors.forename: R C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D015897:Comorbidity; D003466:Cultural Characteristics; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004243:Divorce / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D014943:Global Health; D006801:Humans; D038622:Internationality; D008297:Male; D008393:Marriage / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology; D008875:Middle Aged; D011159:Population Surveillance; D015985:Precipitating Factors; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors