Effect of Marriage on Risk for Onset of Alcohol Use Disorder: A Longitudinal and Co-Relative Analysis in a Swedish National Sample.
- Authors
- Kendler, Kenneth S; LΓΆnn, Sara Larsson; Salvatore, Jessica; Sundquist, Jan; Sundquist, Kristina
- Year
- 2016
- Journal
- The American journal of psychiatry
- PMID
- 27180900
- DOI
- 10.1176/appi.ajp.2016.15111373
- PMCID
- PMC5008987
OBJECTIVE: The authors sought to clarify the relationship between marriage and risk for alcohol use disorder. METHOD: The association between marital status and risk for first registration for alcohol use disorder in medical, criminal, and pharmacy registries was assessed in a population-based Swedish cohort (N=3,220,628) using longitudinal time-dependent survival and co-relative designs. RESULTS: First marriage was associated with a substantial decline in risk for onset of alcohol use disorder in men (hazard ratio=0.41, 95% CI=0.40-0.42) and women (hazard ratio=0.27, 95% CI=0.26-0.28). This association was slightly stronger when the spouse had no lifetime alcohol use disorder, while marriage to a spouse with lifetime alcohol use disorder increased risk for subsequent alcohol use disorder registration in both men (hazard ratio=1.29, 95% CI=1.16-1.43) and women (hazard ratio=1.18, 95% CI=1.06-1.30). In both sexes, the protective effect of marriage was significantly stronger in those with than those without a family history of alcohol use disorder. In both men and women, the associations between marriage and risk for alcohol use disorder in cousins, half siblings, full siblings, and monozygotic twins discordant for marital status were as strong as that seen in the general population. CONCLUSIONS: First marriage to a spouse with no lifetime alcohol use disorder is associated with a large reduction in risk for alcohol use disorder. This association cannot be explained by standard covariates or, as indicated by co-relative analyses, familial genetic or shared environmental confounders. These results are consistent with the hypothesis that the psychological and social aspects of marriage, and in particular health-monitoring spousal interactions, strongly protect against the development of alcohol use disorder. The protective effects of marriage on risk for alcohol use disorder are increased in those at high familial risk for alcoholism.
No figures extracted from this document.
| Name | Type |
|---|---|
| 1960-1990 birth cohort local | cohort |
| alcohol | phenotype |
| Alcohol Problems | phenotype |
| Alcohol Use Disorder | phenotype |
| antisocial individuals local | phenotype |
| antisocial personality disorder | phenotype |
| birth year | phenotype |
| cohabiting couples local | cohort |
| cousins local | cohort |
| Cousins local | cohort |
| crime | phenotype |
| drinking | phenotype |
| drug dependence | phenotype |
| early criminal behavior local | phenotype |
| Early-onset deviant behavior local | phenotype |
| Early-Onset Externalizing Syndromes local | phenotype |
| Epidemiologic Surveys local | cohort |
| family history of alcoholism | phenotype |
| family history positive | phenotype |
| first cousins local | cohort |
| Full-sibling pair local | cohort |
| full siblings local | cohort |
| Full Siblings local | cohort |
| general population | cohort |
| genetic risk | cohort |
| Half-sibling pair local | cohort |
| half siblings local | cohort |
| Half Siblings local | cohort |
| heavy drinking | phenotype |
| Husbands local | cohort |
| Individuals with elevated familial risk for alcoholism local | cohort |
| marital status | phenotype |
| Marriage-discordant siblings local | cohort |
| Marriage to a wife with a history of registration for alcohol use disorder local | phenotype |
| Marriage to Wife with Alcohol Use Disorder local | cohort |
| Marriage to Wife without Alcohol Use Disorder local | cohort |
| married individuals | cohort |
| men | cohort |
| Monozygotic twin pair local | cohort |
| Multigeneration register local | cohort |
| National Epidemiologic Survey on Alcohol and Related Conditions III local | cohort |
| Negative Family History of Alcohol Use Disorder local | phenotype |
| No Family History local | cohort |
| No registration for alcohol use disorder local | phenotype |
| Norway | cohort |
| Outpatient Care register local | cohort |
| parental education | phenotype |
| Parental Education local | cohort |
| Positive family history of alcoholism | phenotype |
| Positive Family History of Alcohol Use Disorder local | phenotype |
| Prescribed Drug register local | cohort |
| Primary Health Care Register local | cohort |
| Same-sex cousin pair local | cohort |
| Severe Problem Drinkers local | phenotype |
| sex | phenotype |
| Single | phenotype |
| socioeconomic status | phenotype |
| Spouse Alcohol Use Disorder local | phenotype |
| Spouse History of Alcohol Use Disorder local | phenotype |
| Spouse with Alcohol Use Disorder local | phenotype |
| Spouse without Alcohol Use Disorder local | phenotype |
| Spouse with prior Alcohol Use Disorder before marriage local | phenotype |
| study cohort | cohort |
| Swedish Crime Register | cohort |
| Swedish general population local | cohort |
| Swedish Hospital Discharge Register | cohort |
| Swedish Mortality Register local | cohort |
| Swedish National Census local | cohort |
| Swedish registers local | cohort |
| Swedish Suspicion Register local | cohort |
| Swedish Twin Registry | cohort |
| Total Population Register local | cohort |
| Twin cohort | cohort |
| women | cohort |
| Year of Birth local | cohort |
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