TY - JOUR
T1 - Duration and timing of depression and risk of family dissolution
T2 - A register-based cohort study of newly-formed Danish families
AU - Lolk, Kasper
AU - Rytgaard, Helene Charlotte Wiese
AU - Madsen, Malene Galle
AU - Arteaga-Henríquez, Gara
AU - Madsen, Kathrine Bang
AU - Dreier, Julie Werenberg
AU - Munk-Olsen, Trine
N1 - Copyright © 2024. Published by Elsevier B.V.
PY - 2024/3/15
Y1 - 2024/3/15
N2 - 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: 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: 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: 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: Depression is disruptive to family stability, particularly with longer duration and early onset after family formation.
AB - 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: 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: 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: 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: Depression is disruptive to family stability, particularly with longer duration and early onset after family formation.
KW - Affective disorders
KW - Antidepressant drugs
KW - Causality
KW - Divorce
KW - Longitudinal
KW - Relationship
KW - Denmark/epidemiology
KW - Depression/epidemiology
KW - Humans
KW - Antidepressive Agents/therapeutic use
KW - Depressive Disorder/drug therapy
KW - Cohort Studies
UR - http://www.scopus.com/inward/record.url?scp=85182555220&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2024.01.022
DO - 10.1016/j.jad.2024.01.022
M3 - Journal article
C2 - 38199414
SN - 0165-0327
VL - 349
SP - 420
EP - 430
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -