title: Prevalence of major depressive disorder among spouses of men who use alcohol in a rural community in Central Sri Lanka.
abstract: OBJECTIVE
  To estimate the prevalence of major depressive disorder (MDD) among spouses of men who use alcohol in two rural areas in Sri Lanka, and to examine whether the severity of alcohol-related problems (ARPs) in men and presence of alcohol-related domestic violence are associated with MDD among these women.
  
  
  METHODS
  In a cross-sectional study, ARPs among men were assessed using Alcohol Use Disorders Identification Test (AUDIT) questionnaire filled in by men, and domestic violence and husbands' drinking pattern data obtained from the women. MDD among the women was ascertained using the Structured Clinical Interview for DSM-IV Disorders for major depression. Using logistic regression we examined whether age, past history of depression, different indices of ARPs and domestic violence were associated with current MDD among the women.
  
  
  RESULTS
  Point prevalence of MDD in the sample was 33.3% (95% CI: 25.93, 40.73%). Once adjusted for other factors, morning drinking of the spouse (odds ratio = 4.11, 95% CI: 1.25, 13.47; P = 0.019) and increasing age (odds ratio = 1.05, 95% CI: 1.01, 1.09; P = 0.003) significantly increased the odds of MDD. Being subjected to domestic violence/arguments also had a trend to be associated with MDD among women, but was not significant (odds ratio = 2.29, 95% CI: 0.95, 5.48; P = 0.062).
  
  
  CONCLUSIONS
  The prevalence of MDD among spouses of men who use alcohol is markedly higher than that has been observed among Sri Lankan women in previous studies. The prevalence of MDD in women seems to increase when their husbands are morning drinkers, and with increasing age.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka dewasmika.ariyasinghe@gmail.com.
authors.forename: Dewasmika
authors.initials: D
authors.lastname: Ariyasinghe
authors.affiliation: Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
authors.forename: Ranil
authors.initials: R
authors.lastname: Abeysinghe
authors.affiliation: South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
authors.forename: Prabhash
authors.initials: P
authors.lastname: Siriwardhana
authors.affiliation: Department of Physiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
authors.forename: Tharaka
authors.initials: T
authors.lastname: Dassanayake
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking; D000437:Alcoholism; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D012720:Severity of Illness Index; D013179:Spouse Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D018454:Spouses / Q000523:psychology / Q000706:statistics & numerical data*; D013188:Sri Lanka / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014930:Women / Q000523:psychology*; D055815:Young Adult