Thursday, February 8, 2018

For Better or Worse: Risk of Alcohol Use Disorder Rises When Spouse Is Diagnosed

A study of married couples in Sweden found that spouses strongly resemble one another in their risk for alcohol use disorder (AUD), with the way spouses interact with each other playing a strong causal role, according to a report published yesterday in JAMA Psychiatry.

Women in a first marriage with no history of AUD were nearly 14 times more likely to be diagnosed with AUD immediately after their husbands were diagnosed with AUD and about four times as likely after two years, compared with women who had no spousal exposure to AUD, according to Kenneth S. Kendler, M.D., at the Virginia Institute for Psychiatric and Behavioral Genetics and colleagues. Similarly, husbands with no history of AUD were more than nine times as likely to be diagnosed with AUD immediately after their wives were diagnosed, and about three times as likely after three years.

Researchers examined population, medical, pharmacy, and crime registries in Sweden to determine marital and AUD status, excluding married partners who did not reside together. First, they identified 8,562 married couples where neither had a history of AUD prior to marriage and one spouse developed AUD during the marriage. These couples were compared with individuals who did not reside with a spouse with an AUD. The researchers then studied 4,891 individuals with multiple marriages whose first spouse had no AUD diagnosis and second spouse did, or vice versa.

Researchers noted that individuals who remarried were more likely to move from having a spouse without AUD to a spouse with AUD than vice versa. When individuals moved from a marriage to a spouse with AUD to a spouse without the disorder, they cut their risk for AUD by half. By contrast, individuals who moved from a marriage to a spouse without the disorder to one with AUD greatly increased their risk of AUD (seven times the risk in women, and nine times the risk in men).

The report follows a 2016 study published in the American Journal of Psychiatry that men and women married to a spouse with no history of AUD are much less likely to experience AUD themselves. It concluded that while marriage generally was protective against the risk of alcohol use disorder, marriage to a spouse with AUD greatly increased the risk of the disorder for both men and women.

“Although genetic and biological factors contribute strongly to the predisposition to alcohol dependence, these findings complement our prior work on marriage and divorce in showing how close social bonds such as marriage can also powerfully influence, for better or worse, the risk for AUD,” the researchers concluded.

For related information, see the Psychiatric News article “Marriage May Decrease Future Risk of Alcohol Use Disorder.”

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