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      Divorce and subsequent increase in uptake of antidepressant medication: a Finnish registry-based study on couple versus individual effects

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          Abstract

          Background

          There is an average negative mental health effect for individuals who experience divorce. Little is known whether the pattern of such divorce effects varies within couples. We study whether the husband and wife experience similar harmful effects of divorce, whether they experience opposite effects, or whether divorce effects are purely individual.

          Methods

          We use Finnish registry data to compare changes over a period of 5 years in antidepressant use of husbands and wives from 4,558 divorcing couples to 108,637 continuously married pairs aged 40–64, all of whom were healthy at baseline.

          Results

          In the period three years before and after divorce antidepressant use increases substantially. However, the likelihood of uptake of antidepressant medication during this process of divorce by one partner appears to be independent of medication uptake in the other partner. In contrast, among continuously married couples there is a clear pattern of convergence: If one partner starts to use antidepressants this increases the likelihood of uptake of antidepressant medication in the other partner.

          Conclusions

          Our findings suggest that divorce effects on antidepressant use are individual and show no pattern of either convergence or divergence at the level of the couple. The increased incidence of antidepressant use associated with divorce occurs in individuals independent of what happens to their ex-partner.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12889-015-1508-9) contains supplementary material, which is available to authorized users.

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          Most cited references26

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          Has the future of marriage arrived? A contemporary examination of gender, marriage, and psychological well-being.

          A long tradition of research and theory on gender, marriage, and mental health suggests that marital status is more important to men's psychological well-being than women's while marital quality is more important to women's well-being than men's. These beliefs rest largely on a theoretical and empirical foundation established in the 1970s, but, despite changes in gender and family roles, they have rarely been questioned. The present analysis of three waves of a nationally representative survey indicates that, with few exceptions, the effects of marital status, marital transitions, and marital quality on psychological well-being are similar for men and women. Further, for men and women, occupying an unsatisfying marriage undermines psychological well-being to a similar extent--and, in some cases, to a greater extent--than exiting marriage or being continually unmarried.
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            The social consequences of psychiatric disorders, III: probability of marital stability.

            The associations of prior DSM-III-R disorders with probability and timing of subsequent divorce were examined. The data came from the part II subsample (N=5,877) of the National Comorbidity Survey. The respondents completed a structured diagnostic interview that retrospectively dated age at onset of each of 14 lifetime DSM-III-R disorders and recorded ages at first marriage and divorce. These data were used to estimate survival models describing the relationships between prior disorders and subsequent divorce. In addition, simulations were used to estimate the number of years spent out of marriage because of these causal relationships in the total U.S. population. Prior psychiatric disorders were associated with a substantially higher risk of divorce. The simulations suggested that the effects of these associations in the U.S. population in the survey's age range are approximately 23 million lost years of marriage among men and 48 million lost years of marriage among women. Psychiatric disorders have a number of adverse consequences for those who suffer from them and for their families and communities. The results reported here suggest that an increase in the number of people who divorce and a decrease in the number of years of marriage in the population may be among them. The debate over whether society can afford to provide universal treatment for psychiatric disorders needs to take these costs into consideration.
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              An Empirical Test of Crisis, Social Selection, and Role Explanations of the Relationship Between Marital Disruption and Psychological Distress: A Pooled Time-Series Analysis of Four-Wave Panel Data

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                Author and article information

                Contributors
                christiaan.monden@nuffield.ox.ac.uk
                niina.metsa-simola@helsinki.fi
                saarioja@gmail.com
                pekka.martikainen@helsinki.fi
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                19 February 2015
                19 February 2015
                2015
                : 15
                : 158
                Affiliations
                [ ]Department of Sociology, Manor Road, OX1 3UQ Oxford, United Kingdom
                [ ]Population Research Unit, University of Helsinki, Helsinki, Finland
                Article
                1508
                10.1186/s12889-015-1508-9
                4341230
                0b5a2e59-2e38-4ffc-84ab-79fb626e3ed0
                © Monden et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 8 October 2014
                : 5 February 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Public health
                divorce,antidepressants,mental health,couples,marriage,finland
                Public health
                divorce, antidepressants, mental health, couples, marriage, finland

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