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In Canada, an estimated 4 marriages in 10 will end before the couple celebrate their 30th wedding  anniversary.1  The most recent data available from the Divorce Registry show that nearly 71,000 married couples divorced in 2003;1-3 thousands more separated.
 
Nationally representative cross-sectional and longitudinal studies from the United States and Europe suggest that, compared with people who remain together, those who have experienced marital breakdown are at increased risk of mental health problems.4-11  Canadian research on the subject is more limited, and most of it is cross-sectional.12-16

This article uses longitudinal data from Statistics Canada's National Population Health Survey (NPHS) to examine associations between marital dissolution and subsequent depression among people aged 20 to 64 (see Methods and Limitations).  Specifically, the analysis tests the hypothesis that two-year incident depression is more common among individuals who have recently experienced marital dissolution than among those who remained married.  Given the prevalence of common-law unions, people who identified their marital status as “common-law” or “living with a partner” (see Definitions) are included as part of the study population.17-19  Thus, in this analysis the term “marital dissolution” includes the termination of these cohabitating relationships.

The end of a marriage (legal or common-law) brings other disruptive life changes, which in themselves might be detrimental to mental health.  Therefore, in this analysis, several potentially confounding factors were taken into account in multivariate analyses including:  changes over a two-year period in household income, social support, presence and number of children in the household, and employment status.  Because depression tends to recur, history of depression, in addition to educational attainment and age, were also controlled.5,9‑11,15,16,29,30  Unadjusted odds ratios were calculated to examine the strength of the association between marital dissolution and incident depression before potential confounders were considered.

Marital dissolution and depression
Women’s economic well-being suffers
Social support disrupted
Men no longer live with children
Employment patterns not likely to change
Marital breakdown independently associated with depression
For many, depression short term
Concluding remarks

Marital dissolution and depression

Averaged over each two-year interval from 1994/1995 to 2004/2005, 4.2% of people aged 20 to 64 who had been married or living with a common-law partner at the time of their baseline NPHS interview were no longer in a relationship when they were re-interviewed two years later (see Methods) (data not shown).  

Among married people who did not report having had symptoms of depression in the year before their baseline interview, a new depressive episode was nearly four times as common (12%) if they were separated, divorced or single at the follow-up interview, compared with those who remained in a relationship (3%) (data not shown).

Earlier studies have found sex differences in the association between marital dissolution and mental health.27-29,31  Analysis of NPHS data indicated that men whose marriages ended were at higher risk of depression than were women.  In relation to depression, the interaction term (marital dissolution*male) was statistically significant, suggesting that marital dissolution was more detrimental to the mental health of men than of women (data not shown).  Because of this difference, sex-specific analyses were conducted.

Marital dissolution often sets in motion a series of stressful disruptions that create further personal and financial difficulties,31,34 which themselves may contribute to depression.  Thus, it is possible that marital dissolution is a surrogate for the other life changes that come in its wake, and that may be more directly related to incident depression.  In this analysis, emphasis is placed on determining if marital dissolution is associated with depression, independent of other life changes and factors.       

Women’s economic well-being suffers

Financial difficulties often follow marital dissolution, as the original family income is divided between two households and economies of scale are less pertinent.  Consistent with other research,29,30,34,35  analysis of NPHS data shows that a substantially higher proportion of women than men experienced a drop in income after a break-up (even when adjusted for household size).  Women who experienced marital dissolution were nearly three times as likely as their male counterparts to have a drop of at least one quintile in the ranking of their household income (Chart 1).   As a result, after a break-up, women tended to live in households with an income ranking far below that of their male counterparts:  men’s average household income decile was 6.3, compared with 4.1 for women (decile 1 is the bottom 10% of the household income distribution; decile 10, the highest 10%) (data not shown).   Moreover, nearly 30% of recently divorced or separated men actually experienced an improvement in the ranking of their adjusted household income; the comparable figure for women was less than 10%.  

Social support disrupted

Marital dissolution can change the amount of social support available to an individual.  A break-up means not only the loss of a partner, but can also reduce the size of a social network by dividing extended family and mutual friends.  The loss of social support may be particularly difficult for men.  Many men rely solely on their partner for support, while women tend to have larger social networks.19

People who experienced a break-up were more likely than those who remained married  to report a decline in social support between their baseline and follow-up interviews (Chart 2).  Whereas 19% of men who were no longer with their spouse reported a drop in social support, the figure was 6% for those who remained in a relationship.  Among women, the corresponding proportions were 11% and 5%. 

Men no longer live with children

Research has suggested that loss of custody or a change in parental responsibilities is one of the most stressful aspects of post-divorce life for men.36  According to the analysis of NPHS data, 34% of men and 3% of women whose relationship ended were residing with at least one fewer child(ren) between their baseline and follow-up interviews (Chart 3). 

Employment patterns not likely to change

The breakdown of a marital relationship may mean a change in employment status, which could have some effect on mental health.  However, analysis of the longitudinal NPHS data showed no statistically significant differences in employment status over the two years between married and divorced/separated men (Chart 4).  Among women, differences in employment status were significant only among those who remained consistently unemployed or who were employed at both times.

Marital breakdown independently associated with depression

Compared with men who remained married, those who underwent a break-up over a two-year period had six times the odds of reporting symptoms of depression.  Among women, the unadjusted odds of two-year incident depression were three and a half times greater if their relationship ended (Table 1, unadjusted odds).   When the effects of changes in income, social support, presence of children and employment status, as well as a history of depression, education and age, were taken into account, the relationship between marital dissolution and two-year incident depression remained statistically significant for both sexes, although the strength of the association was reduced (Table 1, adjusted odds).  The adjusted odds of depression for men whose relationship ended were about three times those of men who remained with their spouse; for women, the adjusted odds of depression after a break-up were about two and a half times greater.  The weakening of the association between marital dissolution and depression suggests that other factors that may accompany a break-up, notably changes in income and social support, contributed to the risk of experiencing incident depression among men and women.

For many, depression short term

For the majority of individuals who experienced depression in the post-relationship period, the passage of time was beneficial.  More than three-quarters of those who had had a depressive episode in the two-year period associated with the break-up did not report another episode when they were re-interviewed after another two years had passed (that is, four years later) (data not shown).

Concluding remarks

These longitudinal results from the National Population Health Survey support the hypothesis that marital dissolution is linked to subsequent depression.  This association persisted even when other events that often accompany a break-up — change in adjusted household income, change in social support, change in number of children in household, change in work status — were taken into account, along with having a history of depression, educational attainment and age.  While some of these factors were associated with an increased risk of depression, they did not completely account for it.  The results are consistent with the findings of other longitudinal studies.5,8,11,31,41 

Also, as reported in previous research,27-29,31 the NPHS data show sex differences in the association between marital dissolution and mental health.  Men who experienced a break-up were more at risk of experiencing depression than were women.

The longer-term follow-up suggests that, for the majority, depression was isolated to the period immediately surrounding the break-up.  Nonetheless, depression continued to be a problem for a sizable minority four years later.  Given the frequency of divorce and separation and its association with mental health problems, these findings are relevant to population health.