Affiliations 

  • 1 Faculty of Applied Sciences, Macao Polytechnic University, Macau, Macau SAR
  • 2 Department of Radiology, Changzhi Medical College, Changzhi, China
  • 3 Vanke School of Public Health, Tsinghua University, Beijing, China
  • 4 School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR
  • 5 Faculty of Health and Life Sciences, INTI International University, Nilai, Malaysia
  • 6 Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA. cuicuiwang@hsph.harvard.edu
  • 7 Faculty of Applied Sciences, Macao Polytechnic University, Macau, Macau SAR. kefengl@mpu.edu.mo
Nat Hum Behav, 2024 Dec;8(12):2392-2405.
PMID: 39496771 DOI: 10.1038/s41562-024-02033-0

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 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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