Origins of spousal cross-concordance for psychiatric disorders : A test of the social stress theory for alcohol use disorder
(2023) In Psychological Medicine 53(10). p.4772-4779- Abstract
Background The authors sought to clarify the impact of spousal psychiatric disorders of differing severity [major depression or anxiety disorders (DAD) v. bipolar disorder or nonaffective psychosis (BPN)] on proband risk for alcohol use disorder (AUD) during marriage. Methods In a Swedish cohort (N = 744 628), associations between spousal DAD and BPN and proband AUD were estimated with Cox proportional hazards; associations between parental AUD, proband premarital AUD, and spousal lifetime DAD and BPN were estimated with logistic regression; and whether spousal DAD or BPN causally increased risk for AUD was evaluated with frailty models. Results Spousal premarital DAD, spousal marital-onset DAD, and spousal BPN (premarital or... (More)
Background The authors sought to clarify the impact of spousal psychiatric disorders of differing severity [major depression or anxiety disorders (DAD) v. bipolar disorder or nonaffective psychosis (BPN)] on proband risk for alcohol use disorder (AUD) during marriage. Methods In a Swedish cohort (N = 744 628), associations between spousal DAD and BPN and proband AUD were estimated with Cox proportional hazards; associations between parental AUD, proband premarital AUD, and spousal lifetime DAD and BPN were estimated with logistic regression; and whether spousal DAD or BPN causally increased risk for AUD was evaluated with frailty models. Results Spousal premarital DAD, spousal marital-onset DAD, and spousal BPN (premarital or marital-onset) were associated with proband AUD during marriage [hazard ratios (HR) range 1.44-3.72]. Those with a parental or premarital history of AUD (v. without) were more likely to marry a spouse with DAD or BPN (odds ratios 1.22-2.77). Moving from an unaffected first spouse to a DAD-affected second spouse increased AUD risk in males (HR 2.90). Moving from an unaffected first spouse to a BPN-affected second spouse increased AUD risk (HRmales 3.96; HRfemales 5.64). Moving to an unaffected second spouse from a DAD-affected first spouse decreased AUD risk, with stronger evidence in females compared to males (HRmales 0.59; HRfemales 0.28). Conclusions Associations between spousal DAD or BPN and proband AUD reflect both selection and causal effects. Marriage to a BPN-affected spouse has a particularly strong effect on AUD risk, with more modest effects for spousal DAD.
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- author
- Salvatore, Jessica E. ; Larsson Lönn, Sara LU ; Sundquist, Jan LU ; Sundquist, Kristina LU and Kendler, Kenneth S.
- organization
- publishing date
- 2023-07-22
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Alcohol use disorder, anxiety disorders, bipolar disorder, major depression, nonaffective psychosis, social stress, spousal influences
- in
- Psychological Medicine
- volume
- 53
- issue
- 10
- pages
- 4772 - 4779
- publisher
- Cambridge University Press
- external identifiers
-
- pmid:35730235
- scopus:85153398413
- ISSN
- 0033-2917
- DOI
- 10.1017/S0033291722001738
- language
- English
- LU publication?
- yes
- additional info
- Funding Information: This project was supported by grants R01AA023534 and K01AA024152 from the National Institutes of Health, and the Swedish Research Council (2018-02400). Publisher Copyright: Copyright © The Author(s), 2022. Published by Cambridge University Press.
- id
- 84d43811-a8a0-492c-990b-64db4f3fd91b
- date added to LUP
- 2023-08-28 10:36:12
- date last changed
- 2024-04-20 02:01:53
@article{84d43811-a8a0-492c-990b-64db4f3fd91b,
abstract = {{<p>Background The authors sought to clarify the impact of spousal psychiatric disorders of differing severity [major depression or anxiety disorders (DAD) v. bipolar disorder or nonaffective psychosis (BPN)] on proband risk for alcohol use disorder (AUD) during marriage. Methods In a Swedish cohort (N = 744 628), associations between spousal DAD and BPN and proband AUD were estimated with Cox proportional hazards; associations between parental AUD, proband premarital AUD, and spousal lifetime DAD and BPN were estimated with logistic regression; and whether spousal DAD or BPN causally increased risk for AUD was evaluated with frailty models. Results Spousal premarital DAD, spousal marital-onset DAD, and spousal BPN (premarital or marital-onset) were associated with proband AUD during marriage [hazard ratios (HR) range 1.44-3.72]. Those with a parental or premarital history of AUD (v. without) were more likely to marry a spouse with DAD or BPN (odds ratios 1.22-2.77). Moving from an unaffected first spouse to a DAD-affected second spouse increased AUD risk in males (HR 2.90). Moving from an unaffected first spouse to a BPN-affected second spouse increased AUD risk (HRmales 3.96; HRfemales 5.64). Moving to an unaffected second spouse from a DAD-affected first spouse decreased AUD risk, with stronger evidence in females compared to males (HRmales 0.59; HRfemales 0.28). Conclusions Associations between spousal DAD or BPN and proband AUD reflect both selection and causal effects. Marriage to a BPN-affected spouse has a particularly strong effect on AUD risk, with more modest effects for spousal DAD.</p>}},
author = {{Salvatore, Jessica E. and Larsson Lönn, Sara and Sundquist, Jan and Sundquist, Kristina and Kendler, Kenneth S.}},
issn = {{0033-2917}},
keywords = {{Alcohol use disorder; anxiety disorders; bipolar disorder; major depression; nonaffective psychosis; social stress; spousal influences}},
language = {{eng}},
month = {{07}},
number = {{10}},
pages = {{4772--4779}},
publisher = {{Cambridge University Press}},
series = {{Psychological Medicine}},
title = {{Origins of spousal cross-concordance for psychiatric disorders : A test of the social stress theory for alcohol use disorder}},
url = {{http://dx.doi.org/10.1017/S0033291722001738}},
doi = {{10.1017/S0033291722001738}},
volume = {{53}},
year = {{2023}},
}