Failed Marriages, Fractured Minds

The epidemic of mental illness in recent decades has psychiatrists looking for causes. One of those causes of psychopathology—namely, marital failure—stands out clearly in a study recently completed by an international team of researchers. Affiliated with Kern Medical Center and California State University at Bakersfield in the United States and Chonbuk National University Medical School in Korea, these researchers sought to identify demographic variables predictive of schizophrenia spectrum disorders and affective disorders. And marital status emerged in their analysis as a marker of elevated risk of both types of psychological distress.

The data for the new study comes from the discharge summaries of all 2,051 adult patients admitted between July 2003 and March 2007 to the county mental hospital for Kern County in southern-central California. Parsing these data, the researchers conclude that marital status is one of eight variables—along with “family psychiatric history, length of hospitalization, gender, education, . . . ethnicity, living situation, and insurance”—that were “significantly associated with the diagnosis of schizophrenia spectrum disorder” (p < 0.001 for marital status). In analyzing the data further using statistical models that take into account a range of “clinical variables,” the researchers concluded that “failure of marriage” was just one of four demographic variables—along with “lower education, . . . homelessness, and low quality insurance”—that were still “significantly associated with a diagnosis of schizophrenia.”

A similar pattern emerges when the researchers shift their focus to affective disorders of the psyche. Once again, marital status emerges as one of the statistical predictors (along with “family psychiatric history, length of hospitalization, . . . ethnicity, living situation, and insurance”) of the statistical correlates of mental illness in view (p < 0.001 for marital status). And once again when the researchers re-examined their data with a more sophisticated model controlling for “clinical variables,” they concluded that “failure of marriage” persisted as one of the demographic variables (along with “presence of a family psychiatric history, . . . not-homelessness, and quality insurance”) predicting this form of mental disease.

Of course, those trying to minimize the impact of marital status on psychological well-being could dismiss these findings simply as “selection effects”: that is, a person suffering from mental illness is likely to fail in marriage. But if that were the primary story here, the researchers would not speak, as they do, of how “marriage had a protective effect for men,” evidently shielding them from schizophrenia in ways indicative of how “social risk factors play an important role in the development of [this mental disorder].”

Also reflecting an arrow of causation that runs from marital failure to mental illness, and not the other way around, is the way the researchers interpret their findings against the backdrop of earlier research establishing that individuals who have suffered “divorce or job loss are up to 3 times more likely to develop a major depressive disorder than those without such event.” In the same vein, the researchers cite as a gloss upon their own findings a recent study in which colleagues had monitored the psychological well-being of single and married mothers over a two-year span, concluding that “risk of onset of depression was double among single mothers.”

This new study helps us understand the meaning of five decades of ubiquitous justification for easy divorce and equally ubiquitous devaluation of enduring wedlock: It’s all about employment security for psychiatrists.

(Mal Rye Choi et al., “The Effects of Sociodemographic Factors on Psychiatric Diagnosis,” Psychiatry Investigations 9.3 [2012]: 199-208.)