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Association and causal mediation between marital status and depression in seven countries

Author

Listed:
  • Xiaobing Zhai

    (Macao Polytechnic University)

  • Henry H. Y. Tong

    (Macao Polytechnic University)

  • Chi Kin Lam

    (Macao Polytechnic University)

  • Abao Xing

    (Macao Polytechnic University)

  • Yuyang Sha

    (Macao Polytechnic University)

  • Gang Luo

    (Macao Polytechnic University)

  • Weiyu Meng

    (Macao Polytechnic University)

  • Junfeng Li

    (Changzhi Medical College
    Heping Hospital Affiliated to Changzhi Medical College)

  • Miao Zhou

    (Tsinghua University)

  • Yangxi Huang

    (University of Hong Kong)

  • Ling Shing Wong

    (INTI International University)

  • Cuicui Wang

    (Harvard T.H. Chan School of Public Health)

  • Kefeng Li

    (Macao Polytechnic University)

Abstract

Depression represents a significant global public health challenge, and marital status has been recognized as a potential risk factor. However, previous investigations of this association have primarily focused on Western samples with substantial heterogeneity. Our study aimed to examine the association between marital status and depressive symptoms across countries with diverse cultural backgrounds using a large-scale, two-stage, cross-country analysis. We used nationally representative, de-identified individual-level data from seven countries, including the USA, the UK, Mexico, Ireland, Korea, China and Indonesia (106,556 cross-sectional and 20,865 longitudinal participants), representing approximately 541 million adults. The follow-up duration ranged from 4 to 18 years. Our analysis revealed that unmarried individuals had a higher risk of depressive symptoms than their married counterparts across all countries (pooled odds ratio, 1.86; 95% confidence interval (CI), 1.61–2.14). However, the magnitude of this risk was influenced by country, sex and education level, with greater risk in Western versus Eastern countries (β = 0.36; 95% CI, 0.16–0.56; P

Suggested Citation

  • Xiaobing Zhai & Henry H. Y. Tong & Chi Kin Lam & Abao Xing & Yuyang Sha & Gang Luo & Weiyu Meng & Junfeng Li & Miao Zhou & Yangxi Huang & Ling Shing Wong & Cuicui Wang & Kefeng Li, 2024. "Association and causal mediation between marital status and depression in seven countries," Nature Human Behaviour, Nature, vol. 8(12), pages 2392-2405, December.
    • Handle: RePEc:nat:nathum:v:8:y:2024:i:12:d:10.1038_s41562-024-02033-0
    DOI: 10.1038/s41562-024-02033-0
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