Premarital mental disorders and physical violence in marriage: Cross-national study of married couples

Elizabeth Miller, J. Breslau, M. Petukhova, J. Fayyad, J. Greif Green, L. Kola, S. Seedat, D. J. Stein, A. Tsang, M. C. Viana, L. H. Andrade, K. Demyttenaere, G. De Girolamo, J. M. Haro, C. Hu, E. G. Karam, V. Kovess-Masfety, T. Tomov, R. C. Kessler

Research output: Contribution to journalArticlepeer-review


Background: Mental disorders may increase the risk of physical violence among married couples. Aims: To estimate associations between premarital mental disorders and marital violence in a cross-national sample of married couples. Method: A total of 1821 married couples (3642 individuals) from 11 countries were interviewed as part of the World Health Organization's World Mental Health Survey Initiative. Sixteen mental disorders with onset prior to marriage were examined as predictors of marital violence reported by either spouse. Results: Any physical violence was reported by one or both spouses in 20% of couples, and was associated with husbands' externalising disorders (OR = 1.7, 95% CI 1.2-2.3). Overall, the population attributable risk for marital violence related to premarital mental disorders was estimated to be 17.2%. Conclusions: Husbands' externalising disorders had a modest but consistent association with marital violence across diverse countries. This finding has implications for the development of targeted interventions to reduce risk of marital violence. Declaration of interest: R.C.K. has been a consultant for AstraZeneca, Analysis Group, Bristol-Myers Squibb, Cerner-Galt Associates, Eli Lilly, GlaxoSmithKline, HealthCore, Health Dialog, Integrated Benefits Institute, John Snow, Kaiser Permanente, Matria, Mensante, Merck, Ortho-McNeil Janssen Scientific Affairs, Pfizer, Primary Care Network, Research Triangle Institute, Sanofi-Aventis Groupe, Shire US, SRA International, Takeda Global Research and Development, Transcept Pharmaceuticals and Wyeth-Ayerst; has served on advisory boards for Appliance Computing II, Eli Lilly, Mindsite, Ortho- McNeil Janssen Scientific Affairs, Plus One Health Management and Wyeth-Ayerst; and has had research support for his epidemiological studies from Analysis Group, Bristol-Myers Squibb, Eli Lilly, EPI-Q, GlaxoSmithKline, Johnson & Johnson Pharmaceuticals, Ortho-McNeil Janssen Scientific Affairs, Pfizer, Sanofi-Aventis Group and Shire US.

Original languageEnglish
Pages (from-to)330-337
Number of pages8
JournalBritish Journal of Psychiatry
Issue number4
Publication statusPublished - Oct 2011

ASJC Scopus subject areas

  • Psychiatry and Mental health


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