In this blogpost we wish to highlight the following article as a candidate for a set of Robustness Reports:
Zhai, X., Tong, H. H. Y., Lam, C. K., Xing, A., Sha, Y., Luo, G., Meng, W., Li, J., Zhou, M., Huang, Y., Wong, L. S., Wang, C., & Li, K. (2024). Association and causal mediation between marital status and depression in seven countries. Nature Human Behaviour, 8(12), 2392–2405. https://doi.org/10.1038/s41562-024-02033-0
The 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 < 0.001), among males versus females (β = 0.25; 95% CI, 0.003–0.47; P = 0.047) and among those with higher versus lower educational attainment (β2 = 0.34; 95% CI, 0.11–0.56; P = 0.003). Furthermore, alcohol drinking causally mediated increased later depressive symptom risk among widowed, divorced/separated and single Chinese, Korean and Mexican participants (all P < 0.001). Similarly, smoking was as identified as a causal mediator among single individuals in China and Mexico, and the results remained unchanged in the bootstrap resampling validation and the sensitivity analyses. Our cross-country analysis suggests that unmarried individuals may be at greater risk of depression, and any efforts to mitigate this risk should consider the roles of cultural context, sex, educational attainment and substance use.”
The findings indicate that unmarried individuals are at greater risk of depressive symptoms, especially highly educated males in Western-classified countries. Due to these socially significant and impactful findings, a re-analysis of these large data sets (total N > 127.000) is recommended to increase our confidence in the findings. The different datasets used are publicly available and can be found in the paper’s data availability section..
More information on the Journal of Robustness Reports is available on this site and on BayesianSpectacles.
Author
Jari Holla
References
Zhai, X., Tong, H. H. Y., Lam, C. K., Xing, A., Sha, Y., Luo, G., Meng, W., Li, J., Zhou, M., Huang, Y., Wong, L. S., Wang, C., & Li, K. (2024). Association and causal mediation between marital status and depression in seven countries. Nature Human Behaviour, 8(12), 2392–2405. https://doi.org/10.1038/s41562-024-02033-0