title: Long-term effects of mental disorders on marital outcomes in the National Comorbidity Survey ten-year follow-up.
abstract: OBJECTIVE
  Epidemiological research has consistently shown an association between mental disorders and marital dissolution. However, this research mostly examined the association of divorce as a risk factor for mental illness. This study prospectively examined the associations of mood, anxiety, and substance use disorders with future marital dissolution and new marriages in a representative population sample.
  
  
  METHODS
  The study used data from the National Comorbidity Survey panel study-a two-wave community epidemiological survey of 5001 participants interviewed in 1990-1992 and re-interviewed in 2001-2003. Mental disorders were ascertained with the Composite International Diagnostic Interview, a fully structured instrument. Associations of baseline lifetime disorders and disorders with onset after the baseline with subsequent divorce and marriage/remarriage were examined using discrete-time survival analysis models.
  
  
  RESULTS
  Mental disorders at baseline or with onset after baseline were associated with significantly greater odds of subsequent divorce among respondents who either were married at baseline or got married after baseline. Mental disorders with onset after baseline were associated with smaller odds of marriage or remarriage. Projections assuming causal effects of mental illness on marital outcomes suggest that preventing the effects of common mood, anxiety, and substance use disorders would be associated with 6.7 million fewer divorces and 3.5 million more marriages in the US population over an 11-year period.
  
  
  CONCLUSIONS
  Individuals with common mental disorders are at greater risk of marital dissolution and are less likely to enter new marriages. These factors contribute to the diminished social engagement and social support for individuals with these disorders. Interventions aimed at improving marital and family relationships could potentially ameliorate the effect of mental disorders on these vital social ties.
authors.affiliation: Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA. rmojtab1@jhu.edu.
authors.forename: Ramin
authors.initials: R
authors.lastname: Mojtabai
authors.affiliation: Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Stuart
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Irving
authors.initials: I
authors.lastname: Hwang
authors.affiliation: Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: William W
authors.initials: WW
authors.lastname: Eaton
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Sampson
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology; D011446:Prospective Studies; D018570:Risk Assessment; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D013995:Time; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Divorce; Epidemiology; Marital status; Mental disorders; Social consequences