Get access

An Exploratory Investigation of Marital Functioning and Order of Spousal Onset in Couples Concordant for Psychopathology


  • Kimberly A. Van Orden, PhD, Department of Psychiatry, University of Rochester Medical Center; Scott Braithwaite, PhD, Mike Anestis, PhD, Katherine M. Timmons, MS, Frank Fincham, PhD, and Thomas E. Joiner, PhD, Department of Psychology, Florida State University; Peter M. Lewinsohn, PhD, Oregon Research Institute.

  • This research was supported in part by NIMH awards MH40501, MH50522, MH52588, and NIDA Grant DA12961 awarded to Dr. Peter M. Lewinsohn.

Address correspondence to Kimberly A. Van Orden, University of Rochester Medical Center, 300 Crittenden Blvd, Box PSYCH, Rochester, NY 14642, USA; E-mail:


Individuals with a psychiatric disorder are significantly more likely to have a spouse with a clinical diagnosis—marital concordance. We used a community sample of 304 couples concordant for either major depressive disorder (MDD) or substance use disorders (SUDs) to examine the relationship between marital functioning and gendered patterns of mental health diagnosis onset. For SUD concordance, couples in which wives onset before husbands—despite typical later onset for men—reported lower levels of marital satisfaction compared with couples in which the husband onset first. For MDD concordance, couples in which husbands onset with depression before wives—despite typical later onset for men—reported lower levels of marital satisfaction. These results suggest that for couples concordant for mental diagnoses, it is most problematic for marital functioning for one partner to have an atypically early onset. Implications for treatment targets in marital therapy are discussed.