ازدواج مجدد بعد ازطلاق و خطر افسردگی

Abstract As marriage is associated with lower depression rates compared with being single in men, we aimed to examine if remarriage compared with remaining divorced is also associated with a reduced depression risk. Swedish register data were used to define a cohort of men who were born between 1952 and 1956 and underwent a compulsory military conscription assessment in adolescence. This study population comprised men who were divorced in 1985 (n = 72,246). The risk of pharmaceutically treated depression from 2005 to 2009 was compared for those who remarried or remained divorced between 1986 and 2004. Cox proportional hazards analysis was used to estimate hazard ratios for the risk of depression identified by pharmaceutical treatment, with adjustment for a range of potential confounding factors including childhood and adulthood socioeconomic circumstances, cognitive, physical, psychological and medical characteristics at the conscription assessment. The results showed that, even though divorced men who remarried had markers of lower depression risk in earlier life such as higher cognitive and physical function, higher stress resilience and socioeconomic advantages than men who remained divorced, remarriage was associated with a statistically significant elevated risk of depression with an adjusted hazard ratio (and 95% confidence interval) of 1.27(1.03 1.55), compared with men who remained divorced. Remarriage following divorce is not associated with a reduced risk of depression identified by pharmaceutical treatment, compared with remaining divorced. Interpersonal or financial difficulties resulting from remarriage may outweigh the benefits of marriage in terms of depression risk.

Introduction Marriage is associated with lower rates of depression (Yan et al., 2011) and mortality than being unmarried (Manzoli et al., 2007). Such associations with marriage have been attributed to intimacy and mutual care, emotional reward, increased living standards through stable and improved financial circumstances, extension of kinship and social support, improved access to social services, and engagement in healthier lifestyles (Musick and Bumpass, 2012). However, less is known about whether remarriage compared with a persistently divorced state is associated with a reduced risk of depression. The average rate of marriage has declined, but divorce and remarriage have become more common in OECD countries (OECD, 2014 and United Nations – Department of Economic and Social Affairs – Population Division, 2009). In Sweden, the proportion who marry for the first time has declined from approximately 90% in 1970 to 75% in 2010 (OECD, 2014). Remarriage may be different from a first marriage, as such unions tend to be less stable (Martin and Bumpass, 1989) and may be more often influenced by factors that were absent in first marriages – such as stepchildren and former partners, which may create conflict for reasons such as parenting issues and financial arrangements (Hughes and Waite, 2009 and Skinner et al., 2002) and thus increasing depression risk. Additionally, divorce may be associated with personality traits less suitable for stable relationships (Teachman, 2008), which also can increase stress and depression risk. To our knowledge, comparison of depression risk between those who remained divorced and remarried has been assessed only rarely. Two studies reported that, compared with constantly divorced or widowed men, remarried men had a lower depression risk (Williams, 2003), higher life satisfaction (Williams, 2003) and better self-rated health (Williams and Umberson, 2004). Although informative, these studies had some limitations, including combining divorce with being widowed, which may introduce some heterogeneity. Using longitudinal Swedish register data, we examined whether remarriage is associated with a lower risk of depression compared with being persistently divorced among men born in the 1950s. We examined marital history during 1985–2004 and identified pharmaceutically treated depression during 2005–2009.

5. Conclusions Risk of depression identified by pharmaceutically treated depression was higher in men who remarried compared with those who remained divorced and it seems unlikely that this is due to a selection effect, as the men who remarried were most advantaged and hence had fewer risks for depression prior to remarriage. This suggests that interpersonal or financial difficulties resulting from remarriage can outweigh the benefits of marriage. As expected, men who were married and never divorced had the most notably reduced depression risk.