Marital status and depression among Mexican Americans

Summary Using data from a three-generations study of Mexican Americans in San Antonio, the authors found that, in general, women and unmarried (widowed or divorced-separated) persons had significantly higher scores on the CES-D depression scale than men and married persons even after a number of controls were introduced. However, marital status did not matter in the older generation and divorce-separation lost significance in the third generation after the controls. The authors discuss the findings in light of the place of the elderly in the Mexican American family and in light of rising divorce rates in younger generations.Funded by grant AG04170 from the National Institute on Aging and by a grant from the Hogg Foundation for Mental Health     

Women,work, social support and psychiatric morbidity

Summary Data from a community survey are presented comparing psychiatric morbidity among women (n=1,710), examining the effects of marital status, employment status, and social contacts with significant others, controlling statistically for the effects of age, education, and income. Contrary to earlier results reported by Findlay-Jones and Burvill (1979), we found both married and unmarried women who were employed had lower morbidity rates. Furthermore, analysis of covariance results indicate that when marital status, employment, and social contacts are considered simultaneously, only the latter variable is a significant predictor of psychiatric morbidity among women.This research was supported in part by grant No. HS00368 from the National Center for Health Services Research, and by grant No. MH30118 from the National Institute of Mental Health. Appreciation is expressed to the staff of the Human Population Laboratory, California State Department of Health Services, for their assistance and support. The second author was recipient of Research Scientist Development Award No. K02-MH00047 (National Institute of Mental Health) during this research.     

Twelve-month psychiatric disorder among single and married mothers: the role of marital history.

OBJECTIVE: To examine differences between single and married mothers in the 12-month prevalence of psychiatric disorders. METHODS: The analysis uses data from the National Comorbidity Survey, collected in 1992-1993, and focuses on women aged 15 to 55 years with children (n=1346). Psychiatric disorders are assessed with the University of Michigan Composite International Diagnostic Interview, a survey instrument based on DSM-III-R criteria. RESULTS: Compared with married mothers, previously married mothers have elevated rates of disorders. Prevalences among single mothers who were never married are similar to those among married mothers, but they are generally lower than prevalences among mothers who experience a marital disruption. CONCLUSIONS: These results indicate that marital separation and divorce may be markers for elevated risk for psychiatric disorder among women with children. It is important to consider the impact of marital history on the relation between family structure and psychiatric outcomes.     

Consistency and Timing of Marital Transitions and Survival During Midlife: the Role of Personality and Health Risk Behaviors

Background

Marital status is associated with survival.

Purpose

The aims of this study are to evaluate marital history and timing on mortality during midlife, test the role of pre-marital personality, and quantify the role of health risk behaviors.

Methods

Cox proportional hazard models were run with varying classifications of marital history and sets of covariates.

Results

In fully adjusted models compared to the currently married, lifetime marital history predicts premature mortality with never married at 2.33 times risk of death and ever married at 1.64 risk of death. Midlife marital history shows that not having a partner during midlife (hazard ratio (HR)?=?3.10 formerly married; HR?=?2.59 remaining single) has the highest risk of death. Controlling for personality and health risk behaviors reduces but does not eliminate the impact of marital status.

Conclusion

Consistency of marital status during midlife suggests that lack of a partner is associated with midlife mortality.     

Support groups for parents of children with emotional disorders: A comparison of members and non-members

This study involving more than 800 parents whose children have emotional disorders focuses on comparisons between parents who are members of support groups and those who are not. While no difference was found between members and non-members on most demographic variables, members reported needing and using more information and services and found each more difficult to locate than nonmembers. Thirty-one percent of all respondents identified involvement with other parents as the most helpful activity in coping with their child's problems.This publication was developed with funding from the National Institute on Disability and Rehabilitation Research, U.S. Department of Education and the National Institute of Mental Health, U.S. Department of Health and Human Services, (NIDRR grant number G0087C0222-88).     

Major depressive disorder and marital transition among mothers: results from a national panel study

This analysis employs a national panel study to examine the relationship between marital transition and depression among mothers within the framework of selection and causation processes. The data come from the two-wave, longitudinal National Population Health Survey (NPHS) by Statistics Canada collected in 1994 and again in 1996 focusing on women between 20 and 65 years of age with children living at home (N = 2169). Compared with mothers who remain married, mothers making the transition into single-parenthood had a significantly higher rate of major depression at Time 1, which increased, but not significantly, at Time 2. This suggests that a selection effect may explain the elevated levels of depression among mothers experiencing a marital disruption. Rates of depression among single-parent mothers making the transition into a marital relationship did not decrease significantly between waves nor did the rate differ significantly from stable single-parent mothers at Time 1 or Time 2, suggesting that movement into marriage is not a protective factor.     

Three diagnostic systems for autism: DSM-III,DSM-III-R,and ICD-10

ICD-10 draft research criteria for childhood autism were applied to a previously published data set comparing DSM-III and DSM-III-R to clinicians' diagnoses of autism. The ICD-10 approach paralleled clinicians' patterns of diagnosis and, to a lesser extent, the DSM-III system. Relative to either clinicians, DSM-III, or ICD-10 the DSM-III-R system overdiagnosed the presence of autism. Implications for research and for future revision of diagnostic criteria are discussed.This study was supported by a grant from the McArthur Foundation to the American Psychiatric Association and by grant HD-03008 from the National Institute of Child Health and Human Development, by National Institute of Mental Health grant MH-30929 to the Mental Health Clinical Research Center, and grant MRIS-1416 to the Veleran's Administration. The views expressed in this article are those of the authors and do not represent the official positions of the DSM-IV Task Force, Work Groups, or the American Psychiatric Association. The authors thank Helena Kraemer for her helpful comments.     

Differences in the effects of divorce on major depression in men and women.

OBJECTIVE: The authors examined the relationship between marital disruption and major depressive episodes. METHOD: The analyses were based on longitudinal, community-based data from the New Haven Epidemiologic Catchment Area (ECA) program on respondents 18-60 years old. The presence and history of major depression was assessed by using the National Institute of Mental Health Diagnostic Interview Schedule. RESULTS: Martial disruption was associated with higher prevalence rates of major depression in both men and women, but only men had a greater risk of a first-onset major depression. Differences between men and women in rates of major depression were observed only among married subjects. CONCLUSIONS: These findings suggest that the relationship between marital disruption and major depressive episode differs for men and women. They also provide further evidence that differences between men and women in rates of depression vary by marital status.     

Emotionally handicapped youth in transition: Issues and principles for program development

Seriously emotionally handicapped adolescents face significant transition issues as they move through our system of care and attempt to assume adult role responsibilities in the community. Service delivery efforts must be sensitive to these issues and begin to realistically address the transition needs of this population. Nine integrative principles are discussed which appear essential when developing transition services.This article was developed with funding from the National Institute on Disability and Rehabilitation Research, U.S. Department of Education and the National Institute of Mental Health, U.S. Department of Health and Human Services (NIDRR grant number G008435137). The content of this publication does not necessarily reflect the views or policies of the funding agencies.     

The role of gender in single vs married individuals with bipolar disorder

Background

Despite the importance of marriage as a source of social support, it has been largely neglected in studies of bipolar disorder; and differential effects on men and women have not been explored.

Methods

Data on episodes of depression, mania, and mixed states were collected for the previous 2 years from a sample of 282 bipolar individuals using the National Institute of Mental Health Life Chart Methodology.

Results

Effects unique to women included the following: Bipolar women were significantly more likely to be married. Married women had fewer episodes of depression during the past 2 years than never-married women, and the cumulative severity of depression was lower. There were no differences in diagnostic subtype or age of onset between married and never-married women. Among men, never-married men were more likely to have bipolar I disorder and had an earlier age of onset compared with married men. There were no differences between married and never-married men in frequency, duration, or severity of mood episodes.

Conclusions

Partner selection processes as they relate to bipolar disorder may be different for men and women. The bipolar I diagnostic subtype and early age of onset were associated with a lower likelihood of being married for men, but not for women. Marriage was associated with less depression in women during a 2-year period; but marital status was not associated with disease course differences in men, suggesting that women may be more sensitive to the positive effects of social support available within a stable marital relationship.     

The relationship between major depression and marital disruption is bidirectional

Background: Marital status is important to the epidemiology of psychiatric disorders. In particular, the high prevalence of major depression in individuals with separated, divorced, or widowed status has been well documented. However, the literature is divided as to whether marital disruption results in major depression and/or vise versa. We examined whether major depression influences changes of marital status, and, conversely, whether marital status influences the incidence of this disorder. Methods: We employed data from the longitudinal Canadian National Population Health Survey (1994–2004), and proportional hazards models with time‐varying covariates. Results: Major depression had no effect on the proportion of individuals who changed from single to common‐law, single to married, or common‐law to married status. In contrast, exposure to depression doubled the proportion of transitions from common‐law or married to separated or divorced status (HR=2.0; 95% CI 1.4–2.9 P<0.001). Conversely an increased proportion of nondepressed individuals with separated or divorced status subsequently experienced major depression (hazard ratio, HR=1.3; 95% CI 1.0–1.5 P=0.04). Conclusion: The high prevalence of major depression in separated or divorced individuals is due to both an increased risk of marital disruption in those with major depression, and also to the higher risk of this disorder in those with divorced or separated marital status. Thus a clinically significant interplay exists between major depression and marital status. Clinicians should be aware of the deleterious impact of major depression on marital relationships. Proactive management of marital problems in clinical settings may help minimize the psycho‐social “scar” that is sometimes associated with this disorder. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.     

Outcome of marriage in schizophrenia

Marriage is a social process requiring certain social abilities for it to be successful. Schizophrenia, which can lead to a reduction of such abilities, has been associated with a low marital rate, especially in men. Data on long-term marital outcome are, however, sparse. This paper deals with changing marital status in a cohort of 76 first-onset schizophrenic patients followed-up for 10 years. A fairly high marital rate of 70% was observed in this sample, with more men remaining single and more women facing broken marriages. It was observed that good marital outcome, in terms of getting married and keeping the marriage intact, was associated with a number of clinical and sociodemographic variables. Duration of illness, type of onset, auditory hallucinations and simple depression at intake, unemployment and economic slide during the course of illness and a relapsing course of illness were all related to marital outcome. Outcome in other areas such as clinical, social and occupational functioning discriminated between the groups of good and poor marital functioning.     

Managing medicaid mental health costs: The case of New Hampshire

The authors evaluate a group of mental health system reforms undertaken in recent years by the state of New Hampshire. A key reform was the coordination of authority over Medicaid and state-run mental health programs, which in most states have historically been operated by separate departments. Preliminary evidence suggests that the reforms have encouraged use of private hospitals and have succeeded in restraining the growth of cost per admission.This study was supported by a grant from the Robert Wood Johnson Foundation and grant number K05-MH00832 from the National Institute of Mental Health. The authors are grateful to Robin Clark, Bob Drake, Randy Ellis, and Karen Jacobson for their helpful comments on an earlier draft. Mary Lou Sudders, Assistant Director of the New Hampshire Division of Mental Health and Developmental Services, was helpful in clarifying state fiscal and utilization data.