Duration and timing of depression and risk of family dissolution: A register-based cohort study of newly-formed Danish families.

Affective disorders Antidepressant drugs Causality Divorce Longitudinal Relationship

Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
08 Jan 2024
Historique:
received: 08 06 2023
revised: 30 11 2023
accepted: 03 01 2024
medline: 11 1 2024
pubmed: 11 1 2024
entrez: 10 1 2024
Statut: aheadofprint

Résumé

Depression is detrimental to partnership stability. However, it remains unclear if and how the duration and timing of depression affect the risk of family dissolution. We conducted a Danish register-based cohort study of newly-formed cohabiting and married couples in 2008 and 2009, who were followed from the second year after family formation. Depressive episodes were defined by individual-level prescription patterns of antidepressant drugs (ATC codes N06A) in either partner. Family dissolution was characterized by the discontinuation of a shared residential address. Using Longitudinal Targeted Minimum Loss-based Estimation, we estimated the risk of family dissolution after 5 years of follow-up under various lengths and timings of depressive episodes. There were 102,335 families included. The covariate-adjusted risk of family dissolution in families without depressive episodes was 30.0 % (95 % CI 29.6-30.4 %) and 35.5 % (95 % CI 29.5-41.5 %) in families with at least one depressive episode during follow-up. The risk of family dissolution increased with the duration of depressive episodes to 42.2 % (95 % CI 40.8-43.6 %) for five coherent years of depression. Depression shortly after family formation carried higher risk of family dissolution; this risk was 42.3 % (95 % CI 38.4-46.3 %) for depression experienced in the first year of family formation versus 32.9 % (95 % CI 31.8-34.0 %) in the fifth year of family formation. Proxy measures of depression by antidepressant prescriptions fails to identify milder depression. Annual measures of family dissolution precluded more fine-grained analyses of time-intervals. Depression is disruptive to family stability, particularly with longer duration and early onset after family formation.

Sections du résumé

BACKGROUND BACKGROUND
Depression is detrimental to partnership stability. However, it remains unclear if and how the duration and timing of depression affect the risk of family dissolution.
METHODS METHODS
We conducted a Danish register-based cohort study of newly-formed cohabiting and married couples in 2008 and 2009, who were followed from the second year after family formation. Depressive episodes were defined by individual-level prescription patterns of antidepressant drugs (ATC codes N06A) in either partner. Family dissolution was characterized by the discontinuation of a shared residential address. Using Longitudinal Targeted Minimum Loss-based Estimation, we estimated the risk of family dissolution after 5 years of follow-up under various lengths and timings of depressive episodes.
RESULTS RESULTS
There were 102,335 families included. The covariate-adjusted risk of family dissolution in families without depressive episodes was 30.0 % (95 % CI 29.6-30.4 %) and 35.5 % (95 % CI 29.5-41.5 %) in families with at least one depressive episode during follow-up. The risk of family dissolution increased with the duration of depressive episodes to 42.2 % (95 % CI 40.8-43.6 %) for five coherent years of depression. Depression shortly after family formation carried higher risk of family dissolution; this risk was 42.3 % (95 % CI 38.4-46.3 %) for depression experienced in the first year of family formation versus 32.9 % (95 % CI 31.8-34.0 %) in the fifth year of family formation.
LIMITATIONS CONCLUSIONS
Proxy measures of depression by antidepressant prescriptions fails to identify milder depression. Annual measures of family dissolution precluded more fine-grained analyses of time-intervals.
CONCLUSIONS CONCLUSIONS
Depression is disruptive to family stability, particularly with longer duration and early onset after family formation.

Identifiants

pubmed: 38199414
pii: S0165-0327(24)00033-8
doi: 10.1016/j.jad.2024.01.022
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of competing interest All authors KL, HCWR, MGM, GAH, KBM, JWD and TMO declare no known conflicts of interest that may influence the work reported in this paper. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this paper in consistent with those guidelines.

Auteurs

Kasper Lolk (K)

National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark. Electronic address: Lolk.ncrr@au.dk.

Helene Charlotte Wiese Rytgaard (HCW)

Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Malene Galle Madsen (MG)

National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark.

Gara Arteaga-Henríquez (G)

National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain.

Kathrine Bang Madsen (KB)

National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark.

Julie Werenberg Dreier (JW)

National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark.

Trine Munk-Olsen (T)

National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; Department of Clinical Research, Odense University Hospital, Odense, Denmark.

Classifications MeSH