The most incisive guide to issues facing the American family today . . . An invaluable resource for anyone wishing to stay on the cutting edge of research on family trends.

-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia 

A Wedding Ring—Better than a Prozac Tablet

Bryce J. Christensen and Robert W. Patterson

Around the world, married men and women enjoy a decided advantage in mental health. More particularly, research indicates that in both wealthy and developing countries married individuals are far less vulnerable to depression than their unmarried peers.

To identify the social contexts in which men and women are most likely to suffer a Major Depressive Episode (MDE), a large international team of American, Australian, Latin American, European, and Asian scholars pored over psychological data collected from ten high-income countries (Belgium, France, Germany, Israel, Italy, Japan, Netherlands, New Zealand, Spain, United States) and eight low- to middle-income countries (Brazil [São Paulo], Colombia, India [Pondicherry], China [Shenzhen], Lebanon, Mexico, South Africa, Ukraine). These researchers report, “MDE prevalence estimates varied considerably between countries, with the highest prevalence estimates found in some of the wealthiest countries in the world.” Further analysis highlights the importance of an intact marriage in shielding couples against depression and of marital failure in exposing men and women to such mental illness.

“Marital status,” remark the researchers, “was a consistently significant correlate of MDE.” More particularly, the researchers find a statistically significant elevation of the risk of MDE for men and women who were separated from a spouse (as opposed to those in intact marriages) in twelve of the countries surveyed, with odds ratios (ORs) in these countries ranging from less than 4.0 in five countries to over 8.0 in India, Japan, and Lebanon. The researchers identified a statistically significant elevation of the risk of MDE among men and women who were divorced in seven of the ten developed countries studied and in a four of the eight developing countries, with unusually high ORs in Japan (OR = 5.1), China (OR = 6.2) and Ukraine (OR = 4.2). Interestingly, the researchers report, “Being widowed was less consistently and more modestly associated with MDE.” In other words, losing a spouse through divorce or legal separation is more likely to plunge a person into depression than is losing a spouse through death.

Of course, only those who have had a spouse can lose a spouse. And the researchers find that “in the high-income countries [in the study], there was a significantly increased OR of MDE among the never married.” That is, never-married men and women—like their divorced and separated peers—face a risk of serious depression significantly higher than that found among married peers.

Looking specifically at the United States, the researchers find that, when compared to peers in intact marriages, separated men and women are 300 percent more likely to suffer an episode of major depression, divorced men and women are 70 percent more likely, and the never married are 80 percent more likely (odds ratios of 4.0, 1.7. and 1.8; p<0.05 for all three comparisons).

The researchers conclude that episodes of major depression constitute a “significant public-health concern across all regions of the world” and that such depression is “strongly linked to social conditions.” This international team of scholars calls for “future research . . . to investigate the combination of demographic risk factors that are most strongly associated with MDE.” But the results that have already returned indicate that enduring wedlock is a strong antidote to the social conditions that incubate depression.

(Evelyn Bromet et al., “Cross-National Epidemiology of DSM-IV Major Depressive Episode,” BMC Medicine 9 [July 26, 2011]: 90.)