Mental disorder and caregiver burden in spouses: the Nord-Trøndelag health study

<p>Abstract</p> <p>Background</p> <p>Researchers generally agree that mental disorder represents a burden to the family. The present study concerns the subjective burden of living with a person with mental disorder, more specifically the association between mental disorder in the index person and subjective well-being and symptoms of anxiety and depression in the spouse.</p> <p>Methods</p> <p>Data were obtained from questionnaires administered to the adult population of Nord-Trøndelag County, Norway during the period 1995-1997. The present study is based on a subsample where 9,740 couples were identified. Subjective burden in spouses of persons with mental disorder was compared with subjective burden in spouses of persons without mental disorder, using analysis of variance (ANOVA). All analyses were stratified by sex.</p> <p>Results</p> <p>Adjusting for several covariates, spouses of persons with mental disorder scored significantly lower on subjective well-being and significantly higher on symptoms of anxiety and depression compared to spouses of index persons without mental disorder. Although highly significant, the effect sizes were moderate, corresponding to a difference in standard deviations ranging from .34 - .51.</p> <p>Conclusions</p> <p>Our study supports the notion that there is an association between mental disorder in one partner and subjective burden in the spouse, but not to the same extent that have been reported in earlier studies, as our results do not indicate that a large proportion of the spouses reach a symptom level of anxiety and depression that reflects clinical mental disorder.</p

Childhood Sensorineural Hearing Loss and Divorce in a Large Norwegian Cohort: Results from the HUNT Study

The aim of this study is to investigate the association between childhood sensorineural hearing loss (CSNHL) and divorce in a large, Norwegian cohort. Data from the School Hearing Investigation in Nord-Trøndelag (SHINT), Norway, are combined with registry data on marital status from Statistics Norway and matched controls from the Nord-Trøndelag Health Study (HUNT). The sample includes a total of 50,022 individuals, of which 756 persons were classified with CSNHL (216 with moderate-severe, 294 with mild, and 246 with slight CSNHL). The results from the cox regression analyses showed that people in the group with any CSNHL as well as people with moderate-severe CSNHL had a significantly higher risk of getting divorced compared to the reference group (HR = 1.21, p = .024, 95% CI = 1.03–1.42; HR = 1.33, p = .052, 95% CI = 1.00–1.76, respectively) after controlling for age at first marriage, sex and education. This suggests that CSNHL in one or both partners in a couple could be a potential threat to the marriage

Childhood sensorineural hearing loss and adult mental health up to 43 years later: results from the HUNT study

Abstract Background Hearing loss is a global public health problem putting millions of people at risk of experiencing impediments in communication and potentially impaired mental health. Many studies in this field are based on small, cross sectional samples using self-report measures. The present study aims to investigate the association between childhood sensorineural hearing loss and mental health in adult men and women longitudinally in a large cohort with a matched control group, and hearing is measured by pure-tone audiometry. Studies of this kind are virtually non-existing. Methods The present study combines data from two large studies; the School Hearing Investigation in Nord-Trøndelag (SHINT) carried out yearly from 1954 to 1986, and the second wave of the Nord-Trøndelag Health Study (HUNT 2) conducted from 1995 to 1997. The participants were 7, 10 or 13 years during the SHINT, and between 20 and 56 years old during HUNT 2. The total sample consisted of 32,456 participants (of which 32,104 in the reference group). Participants with a sensorineural hearing loss in SHINT of 41 dB or more were classified with moderate-severe hearing loss (N = 66), 26–40 dB as mild (N = 66) and 16–25 dB as slight (N = 220). Mental health in adulthood was measured in HUNT 2 by symptoms of anxiety and depression, subjective well-being, and self-esteem. The association between childhood sensorineural hearing loss and adult mental health was tested by means of ANOVA. Results There was a significant relation between slight childhood sensorineural hearing loss and lowered subjective well-being in women (B = −.25, p = 0.038). Further investigation of the results revealed a significant association between slight hearing loss and symptoms of anxiety and depression (B = .30, p = 0.054) and between mild hearing loss and lowered self-esteem (B = .63, p = 0.024) among women aged 20–39 years. There were no significant relations between childhood sensorineural hearing loss and any of the three mental health outcomes among men. Conclusions This study suggests that women with slight or mild sensorineural hearing loss from childhood experience elevated levels of symptoms of anxiety and depression, lowered subjective well-being and lowered self-esteem. However, the results should be interpreted with caution due to a lack of power in some analyses

Mental distress predicts divorce over 16 years: The HUNT study Health behavior, health promotion and society

Background The association between mental distress and divorce is well established in the literature. Explanations are commonly classified within two different frameworks; social selection (mentally distressed people are selected out of marriage) and social causation (divorce causes mental distress). Despite a relatively large body of literature on this subject, selection effects are somewhat less studied, and research based on data from both spouses is scarce. The purpose of the present study is to investigate selection effects both at the individual level and the couple level. Methods The current study is based on couple-level data from a Norwegian representative sample including 20,233 couples. Long-term selection effects were tested for by means of Cox proportional hazard models, using mental distress in both partners at baseline as predictors of divorce the next 16 years. Three identical sets of analyses were run. The first included the total sample, whereas the second and third excluded couples who divorced within the first 4 or 8 years after baseline, respectively. An interaction term between mental distress in husband and in wife was specified and tested. Results Hazard of divorce was significantly higher in couples with one mentally distressed partner than in couples with no mental distress in all analyses. There was also a significant interaction effect showing that the hazard of divorce for couples with two mentally distressed partners was higher than for couples with one mentally distressed partner, but lower than what could be expected from the combined main effects of two mentally distressed partners. Conclusions Our results suggest that mentally distressed individuals are selected out of marriage. We also found support for a couple-level effect in which spouse similarity in mental distress to a certain degree seems to protect against divorce