Parallel contagion phenomenon of concordant mental disorders among married couples: a nationwide cohort study

Paternal and maternal psychiatric history and risk of preterm and early term birth: A nationwide study using Swedish registers

BACKGROUND

Women with psychiatric diagnoses are at increased risk of preterm birth (PTB), with potential life-long impact on offspring health. Less is known about the risk of PTB in offspring of fathers with psychiatric diagnoses, and for couples where both parents were diagnosed. In a nationwide birth cohort, we examined the association between psychiatric history in fathers, mothers, and both parents and gestational age.

METHODS AND FINDINGS

We included all infants live-born to Nordic parents in 1997 to 2016 in Sweden. Psychiatric diagnoses were obtained from the National Patient Register. Data on gestational age were retrieved from the Medical Birth Register. Associations between parental psychiatric history and PTB were quantified by relative risk (RR) and two-sided 95% confidence intervals (CIs) from log-binomial regressions, by psychiatric disorders overall and by diagnostic categories. We extended the analysis beyond PTB by calculating risks over the whole distribution of gestational age, including "early term" (37 to 38 weeks). Among the 1,488,920 infants born throughout the study period, 1,268,507 were born to parents without a psychiatric diagnosis, of whom 73,094 (5.8%) were born preterm. 4,597 of 73,500 (6.3%) infants were born preterm to fathers with a psychiatric diagnosis, 8,917 of 122,611 (7.3%) infants were born preterm to mothers with a pscyhiatric diagnosis, and 2,026 of 24,302 (8.3%) infants were born preterm to both parents with a pscyhiatric diagnosis. We observed a shift towards earlier gestational age in offspring of parents with psychiatric history. The risks of PTB associated with paternal and maternal psychiatric diagnoses were similar for different psychiatric disorders. The risks for PTB were estimated at RR 1.12 (95% CI [1.08, 1.15] p < 0.001) for paternal diagnoses, at RR 1.31 (95% CI [1.28, 1.34] p < 0.001) for maternal diagnoses, and at RR 1.52 (95% CI [1.46, 1.59] p < 0.001) when both parents were diagnosed with any psychiatric disorder, compared to when neither parent had a psychiatric diagnosis. Stress-related disorders were associated with the highest risks of PTB with corresponding RRs estimated at 1.23 (95% CI [1.16, 1.31] p < 0.001) for a psychiatry history in fathers, at 1.47 (95% CI [1.42, 1.53] p < 0.001) for mothers, and at 1.90 (95% CI [1.64, 2.20] p < 0.001) for both parents. The risks for early term were similar to PTB. Co-occurring diagnoses from different diagnostic categories increased risk; for fathers: RR 1.10 (95% CI [1.07, 1.13] p < 0.001), 1.15 (95% CI [1.09, 1.21] p < 0.001), and 1.33 (95% CI [1.23, 1.43] p < 0.001), for diagnoses in 1, 2, and ≥3 categories; for mothers: RR 1.25 (95% CI [1.22, 1.28] p < 0.001), 1.39 (95% CI [1.34, 1.44] p < 0.001) and 1.65 (95% CI [1.56, 1.74] p < 0.001). Despite the large sample size, statistical precision was limited in subgroups, mainly where both parents had specific psychiatric subtypes. Pathophysiology and genetics underlying different psychiatric diagnoses can be heterogeneous.

CONCLUSIONS

Paternal and maternal psychiatric history were associated with a shift to earlier gestational age and increased risk of births before full term. The risk consistently increased when fathers had a positive history of different psychiatric disorders, increased further when mothers were diagnosed and was highest when both parents were diagnosed.

Mental health and labor supply: Evidence from Canada

This study investigates the relationship between mental health and employment using an instrumental variable approach with the 2012 Canadian Community Health Survey-Mental Health. Using a family member's mental health problem(s) as an instrument for poor mental health, the estimates reveal that poor mental health significantly reduces employment outcomes. These findings are robust to various specifications, such as an alternative instrument and a relaxation of the exclusion restriction assumption. In addition, the relationship is driven mainly by men and younger workers. Moreover, the findings suggest that the relationship is mediated by a decline in cognitive abilities, such as difficulties in concentration and motivation, and social relations with acquaintances and friends. Finally, the estimates show that this phenomenon is contagious: poor mental health has a significant spillover effect on coworkers' mental health in workplaces. This study demonstrates the importance of mental health illness in Canada and other developed countries.

Spillover and crossover effects of working time demands on work-life balance satisfaction among dual-earner couples: the mediating role of work-family conflict

To examine the spillover and crossover effects of working time demands (specifically, work contact in leisure time, evening work, and long work hours) on satisfaction with work-life balance among dual-earner couples, path analyses were conducted using data from the 2017/2018 German Family Panel (pairfam; N = 1,053 dual-earner couples). Working time demands were measured based on (a) answering work emails/phone calls in leisure time, (b) evening work, and (c) weekly work hours. High working time demands impaired workers' work-life balance satisfaction due to higher levels of work-life conflict. They indirectly affected partners' work-life balance satisfaction through two pathways: (a) workers' and partners' work-life conflict and (b) workers' work-life conflict and work-life balance satisfaction. These findings indicate that high working time demands negatively impact the work-life balance satisfaction of workers and their partners because of work-life conflict experienced either by the workers only or by both partners. In an increasingly digitalized labor market, measures are needed to reduce working time demands-and thus work-life conflict-for workers and their partners.

Spousal Concordance and Cross-Disorder Concordance of Mental Disorders: A Nationwide Cohort Study

OBJECTIVE

Although both partners of a married couple can have mental disorders, the concordant and cross-concordant categories of disorders in couples remain unclear. Using national psychiatric population-based data only from patients with mental disorders, we examined married couples with mental disorders to examine spousal concordance and cross-disorder concordance across the full spectrum of mental disorders.

METHODS

Data from the 1997 to 2012 Taiwan Psychiatric Inpatient Medical Claims data set were used and a total of 662 married couples were obtained. Concordance of mental disorders was determined if both spouses were diagnosed with mental disorder of an identical category in the International Classification of Diseases, Ninth Revision, Clinical Modification; otherwise, cross-concordance was reported.

RESULTS

According to Cohen's kappa coefficient, the most concordant mental disorder in couples was substance use disorder, followed by bipolar disorder. Depressive and anxiety disorders were the most common cross-concordant mental disorders, followed by bipolar disorder. The prevalence of the spousal concordance of mental disorders differed by monthly income and the couple's age disparity.

CONCLUSION

Evidence of spousal concordance and cross-concordance for mental disorders may highlight the necessity of understanding the social context of marriage in the etiology of mental illness. Identifying the risk factors from a common environment attributable to mental disorders may enhance public health strategies to prevent and improve chronic mental illness of married couples.

Spillover effect of psychological distress from distressed to non-distressed spouse: A cohort study for midlife married couples in Japan

BACKGROUND

Few studies have evaluated the impact of spousal psychological distress on an individual's distress over time based on detailed measurements of mental status. Hence, we investigate the spillover effect of spousal psychological distress.

METHODS

This cohort study included 11,819 individuals (men, 51.4 %), aged 50-59 (mean 54.7) years, selected from the Japanese nationally representative longitudinal study from 2005 to 2016. Participants were categorized according to their spousal score on the Kessler Psychological Distress Scale (K6) as follows: 0, 1-4, 5-8, 9-12, and 13-24. The incidence of at least moderate distress (K6 ≥ 5) or serious distress (K6 ≥ 13) was determined during follow-up. A complementary log-log discrete time hazard model was constructed.

RESULTS

A total of 5912 and 857 cases of at least moderate and serious distress were identified, with follow-up durations of 72,669 and 105,515 person-years, respectively. Compared with the spousal K6 of 0 group, the multivariable hazard ratios (95 % confidence intervals) of at least moderate distress and serious distress were 1.13 (1.07-1.20) and 1.00 (0.85-1.18) for spousal K6 of 1-4, 1.29 (1.19-1.39) and 1.14 (0.93-1.40) for 5-8, 1.42 (1.26-1.60) and 1.28 (0.95-1.72) for 9-12, and 1.46 (1.22-1.73) and 2.14 (1.49-3.07) for 13-24, respectively. No significant sex differences were observed.

LIMITATIONS

Psychological distress was based on self-reported data without diagnosis by psychiatrists.

CONCLUSIONS

High spousal K6 score contributed to a subsequent higher incidence of one's own at least moderate and serious distress.

Spousal Concordance in Dietary Behaviors and Metabolic Components, and Their Association: A Cross-Sectional Study

This study aims to investigate spousal concordance in dietary behaviors, spousal concordance in metabolic components (MCs), and their association. A cross-sectional survey was conducted in Taiwan from November 2014 to May 2015. Matched-pair analysis, McNemar’s test, logistic regression analysis, and stratified analysis were performed. A total of 901 pairs of spouses (1802 participants) were analyzed. Husbands were less likely to report intakes of high-fiber food (OR_MP (matched pairs odds ratio) = 0.30, p < 0.0001), fish (OR_MP = 0.74, p = 0.0128), biscuits or cakes (OR_MP = 0.60, p < 0.0001), and fast food (OR_MP = 0.65, p = 0.01) compared with their wives. Husbands had significantly higher odds of being overweight (OR_MP = 2.34, p < 0.0001); and of having hypertension (OR_MP = 2.14, p < 0.0001), hypercholesterolemia (OR_MP = 1.75, p = 0.0007), hyperlipidemia (OR_MP = 2.96, p < 0.0001), and one or more metabolic components (composite MCs) (OR_MP = 2.50, p < 0.0001) compared with their wives. After adjusting for age and education, the spousal concordance in high-fiber food intake was inversely associated with the spousal concordance in composite MCs (aOR = 0.62, 95% CI = 0.44–0.88, p = 0.0074), whereas the spousal concordance in processed food intake was positively associated with the concordance in composite MCs (aOR (adjusted odds ratio) = 1.56, 95% CI (Confidence Interval) = 1.03–2.36, p = 0.034). An intervention study for couples with intakes of different fiber foods and/or processed foods is critical for future study, in order to test what kinds of fiber foods/processed foods are associated with the development of the spousal concordance of metabolic components.

Baby Boomers as Caregivers: Results From the Behavioral Risk Factor Surveillance System in 44 States, the District of Columbia, and Puerto Rico, 2015-2017

INTRODUCTION

Baby boomers, people born from 1946 through 1964, represent a substantial portion of the US population. Generally, baby boomers have more chronic disease and disability than those in the previous generation. Frequently, they also provide informal care to others. The objective of our study was to estimate the prevalence of informal caregiving among baby boomers and compare the health of baby boomer caregivers and noncaregivers.

METHODS

Using data from the Behavioral Risk Factor Surveillance System (2015-2017) for 44 states, the District of Columbia, and Puerto Rico, we classified 109,268 baby boomers as caregivers or noncaregivers and compared their general health (poor or fair vs good, very good, or excellent), chronic health conditions, and frequent mental distress (FMD). FMD was defined as 14 days or more of poor mental health in the past month. We used log-binomial regression to calculate prevalence ratios, adjusted for age and sex (aPRs), and to separately estimate aPRs for fair or poor health and FMD or at least one chronic health condition.

RESULTS

One in 4 baby boomers (24.2%) were caregivers. In adjusted models, male caregivers had a higher prevalence of fair to poor health than noncaregivers (aPR = 1.17; 95% confidence interval [CI], 1.06-1.29; P = .001). More caregivers than noncaregivers had at least 1 chronic health condition (aPR = 1.10, 95% CI, 1.07-1.13; P < .001) and more often had FMD (aPR = 1.39; 95% CI, 1.26-1.53; P < .001).

CONCLUSION

Our study showed these caregivers had more chronic health conditions and more often had FMD than noncaregivers. The health of baby boomer caregivers is a public health priority, as these caregivers might need support to maintain their own physical and mental health.

Application of the dyadic data analysis in behavioral medicine research: marital satisfaction and anxiety in infertile couples

BACKGROUND

Dyadic data analysis (DDA) is increasingly being used to better understand, analyze and model intra- and inter-personal mechanisms of health in various types of dyads such as husband-wife, caregiver-patient, doctor-patient, and parent-child. A key strength of the DDA is its flexibility to take the nonindependence available in the dyads into account. In this article, we illustrate the value of using DDA to examine how anxiety is associated with marital satisfaction in infertile couples.

METHODS

This cross-sectional study included 141 infertile couples from a referral infertility clinic in Tehran, Iran between February and May 2017. Anxiety and marital satisfaction were measured by the anxiety subscale of the Hospital Anxiety and Depression Scale and 10-Item ENRICH Marital Satisfaction Scale, respectively. We apply and compare tree different dyadic models to explore the effect of anxiety on marital satisfaction, including the Actor-Partner Interdependence Model (APIM), Mutual Influence Model (MIM), and Common Fate Model (CFM).

RESULTS

This study demonstrated a practical application of the dyadic models. These dyadic models provide results that appear to give different interpretations of the data. The APIM analysis revealed that both men's and women's anxiety excreted an actor effect on their own marital satisfaction. In addition, women's anxiety exerted a significant partner effect on their husbands' marital satisfaction. In MIM analysis, in addition to significant actor effects of anxiety on marital satisfaction, women's reports of marital satisfaction significantly predicted men's marital satisfaction. The CFM analysis revealed that higher couple anxiety scores predicted lower couple marital satisfaction scores.

CONCLUSION

In sum, the study highlights the usefulness of DDA to explore and test the phenomena with inherently dyadic nature. With regard to our empirical data, the findings confirmed that marital satisfaction was influenced by anxiety in infertile couples at both individual and dyadic level; thus, interventions to improve marital satisfaction should include both men and women. In addition, future studies should consider using DDA when dyadic data are available.

"Crossover" in Depressive Symptoms Among Older Couples: Are Previous Findings Artifactual?

Objective: This study examined effects of a partner's depressive symptoms on those of a focal respondent. Method: Data were from the 2008-through-2014 waves of the Health and Retirement Study. Linear growth modeling was used to distinguish within- from between-person variation, and genetic instrumental variables to take endogeneity into account. Results: A partner's 2008 depressive symptoms had no associations with within-person change in those of a respondent between 2010 and 2014. Corresponding linkages with their between-person variation in 2010 were positive and significant for both genders. Among women, these last estimates remained intact in genetic instrumental variable models restricted to white couples. Discussion: Results indicate that contrary to previous literature, late life relationships are not marked by "crossover" of depressive symptoms. Women's affect may, however, be influenced by such transmission in the relationship's history. Beyond depression, findings suggest current theories of dyadic health effects may partly rest on flawed evidence.