Examining cultural background and the protective effect of marriage on alcohol use disorder in Sweden.

IF 2.5 4区医学 Q2 PSYCHIATRY International Journal of Social Psychiatry Pub Date : 2024-10-22 DOI:10.1177/00207640241288211

Jessica E Salvatore, Sara Larsson Lönn, Karen G Chartier, Jan Sundquist, Kenneth S Kendler, Kristina Sundquist

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Abstract

Background: Little is known about whether the protective effect of marriage on alcohol use disorder (AUD) varies by cultural background.

Aims: Using Swedish national data, we examined whether marriage is associated with a stronger reduction in AUD risk among Swedes of a Swedish background (i.e. those with two Swedish-born parents) compared to Swedes with a foreign background (i.e. one or two foreign-born parents) and whether the protective effect of marriage depends on whether the spouse has a Swedish or foreign background.

Method: Among those born in Sweden 1960 to 1990 (3,093,439; 49% female), associations between cultural background and AUD registration during marriage were estimated with Cox models. Analyses of intra- and intermarriage on AUD registration were examined with Cox models and limited to groups of focal individuals for which there was sufficient statistical power, which included Swedes with two Swedish-born parents, two Finnish-born parents, or bicultural background (one Swedish and one foreign-born parent). Models were sex stratified.

Results: Marriage was associated with reductions in AUD risk among those with Swedish and with foreign backgrounds, though less protective for males of Finnish versus Swedish background as indicated by a significant interaction between marital status and parental region of birth, HR = 0.80, 95% CI [0.71, 0.90]. Marriage was also less protective for those with a bicultural versus Swedish background, HR_males = 0.87, 95% CI [0.81, 0.92] and HR_females = 0.88, 95% CI [0.81, 0.97]. Among those of Swedish background, marriage to a spouse with a foreign versus Swedish background was associated with increased risk of AUD, HR_males = 1.26, 95% CI [1.19, 1.34] and HR_females = 1.20, 95% CI [1.10, 1.31]. This risk was diminished when family-level confounders (genes, rearing environment) were controlled for.

Conclusions: The protective effect of marriage depends on cultural background, with some evidence that increased risks associated with a spouse's foreign background are confounded by family-level factors.

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研究瑞典的文化背景和婚姻对酒精使用障碍的保护作用。

背景：目的：我们利用瑞典的全国数据，研究了瑞典背景的瑞典人（即父母双方均在瑞典出生）与外国背景的瑞典人（即父母一方或双方均在外国出生）相比，婚姻是否能更有效地降低酒精使用障碍（AUD）的风险，以及婚姻的保护作用是否取决于配偶是瑞典背景还是外国背景：在1960年至1990年期间出生在瑞典的瑞典人（3,093,439人；49%为女性）中，使用Cox模型估算了文化背景与婚姻期间AUD登记之间的关系。使用Cox模型对婚内通婚和通婚对AUD登记的影响进行了分析，分析对象仅限于有足够统计能力的重点人群，包括父母双方均在瑞典出生的瑞典人、父母双方均在芬兰出生的瑞典人或具有双重文化背景的瑞典人（父母一方为瑞典人，一方为外国出生的人）。模型按性别分层：在瑞典和外国背景的人群中，婚姻与降低 AUD 风险有关，但对芬兰裔男性和瑞典裔男性的保护作用较小，这体现在婚姻状况与父母出生地区之间的显著交互作用（HR = 0.80，95% CI [0.71，0.90]）。婚姻对具有双文化背景和瑞典背景的人的保护作用也较弱，男性 HR = 0.87，95% CI [0.81, 0.92]，女性 HR = 0.88，95% CI [0.81, 0.97]。在具有瑞典背景的人群中，与具有外国背景而非瑞典背景的配偶结婚与 AUD 风险增加有关，男性 HR = 1.26，95% CI [1.19，1.34] ，女性 HR = 1.20，95% CI [1.10，1.31]。在控制了家庭层面的混杂因素（基因、抚养环境）后，这一风险有所降低：结论：婚姻的保护作用取决于文化背景，有证据表明，配偶的外国背景增加的风险与家庭层面的因素有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Social Psychiatry PSYCHIATRY-

CiteScore

12.30

自引率

1.30%

发文量

120

期刊介绍： The International Journal of Social Psychiatry, established in 1954, is a leading publication dedicated to the field of social psychiatry. It serves as a platform for the exchange of research findings and discussions on the influence of social, environmental, and cultural factors on mental health and well-being. The journal is particularly relevant to psychiatrists and multidisciplinary professionals globally who are interested in understanding the broader context of psychiatric disorders and their impact on individuals and communities. Social psychiatry, as a discipline, focuses on the origins and outcomes of mental health issues within a social framework, recognizing the interplay between societal structures and individual mental health. The journal draws connections with related fields such as social anthropology, cultural psychiatry, and sociology, and is influenced by the latest developments in these areas. The journal also places a special emphasis on fast-track publication for brief communications, ensuring that timely and significant research can be disseminated quickly. Additionally, it strives to reflect its international readership by publishing state-of-the-art reviews from various regions around the world, showcasing the diverse practices and perspectives within the psychiatric disciplines. This approach not only contributes to the scientific understanding of social psychiatry but also supports the global exchange of knowledge and best practices in mental health care.