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Marriage outcome and relationship with urban versus rural context for individuals with psychosis in a population-based study in China

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Abstract

Purpose

While social integration among individuals with psychosis differs by social context, this has rarely been investigated across urban vs. rural settings. For individuals with psychosis, marriage may be a key component of social integration. This study aims to compare marriage outcomes for individuals with psychosis in urban vs. rural settings in China, where marriage has been almost universal among individuals without psychosis.

Methods

In a large community-based study in four provinces representing 12 % of China’s population, we identified 393 individuals with psychosis (112 never treated). We used adjusted Poisson regression models to compare marriage status for those living in urban (n = 96) vs. rural (n = 297) contexts.

Results

While urban and rural residents had similar impairments due to symptoms, urban female residents were 2.72 times more likely to be unmarried than their rural counterparts (95 % CI 1.19–6.22, p < 0.0176). Stratified analyses indicated that this marital disadvantage occurred primarily among urban females with an earlier age of onset. No differences were found among males.

Conclusions

Our findings indicate that urban contexts impeded opportunities for marriage for female individuals with psychosis. These data suggest that urban women with earlier age of onset have difficulty in marrying which may be related to economic expectations of women in urban areas. Research examining contextual mechanisms that affect marriage may further understanding of social integration in China and other contexts.

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Acknowledgments

Preparation of this manuscript was supported in part by NIMH grant 1R03MH092666-01, which was awarded to the first author. The authors would also like to thank Ren Li, Sara Chung, Debbie Huang, Tanya Singh, and Qi Wei for their administrative assistance in formatting the paper.

Conflict of interest

None.

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Author notes

    Authors and Affiliations

    1. Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 1610, New York, NY, 10032, USA

      Lawrence H. Yang

    2. Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China

      Michael R. Phillips

    3. Departments of Psychiatry and Global Health, Emory University, Atlanta, USA

      Michael R. Phillips

    4. WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing Hui Long Guan Hospital, Beijing, China

      Michael R. Phillips & Xianyun Li

    5. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, USA

      Gary Yu

    6. Shandong Provincial Mental Health Center, Jinan City, Shandong Province, China

      Jingxuan Zhang

    7. Li Tong De Hospital, Hangzhou City, Zhejiang Province, China

      Qichang Shi

    8. 3rd People’s Hospital, Xining City, Qinghai Province, China

      Zhiqiang Song

    9. Tianshui City Mental Hospital, Tianshui City, Gansu Province, China

      Zhijie Ding

    10. Qingdao Mental Hospital Centre, Qingdao City, Gansu Province, China

      Shutao Pang

    11. Global Mental Health Program at Mailman School of Public Health, Columbia University, New York, USA

      Ezra Susser

    12. New York State Psychiatric Institute, New York, USA

      Ezra Susser

    Authors
    1. Lawrence H. Yang
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    2. Michael R. Phillips
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    3. Xianyun Li
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    Correspondence to Lawrence H. Yang.

    Additional information

    Dr. Yang, Dr. Phillips, and Dr. Li, are shared first authors for this manuscript.

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    Yang, L.H., Phillips, M.R., Li, X. et al. Marriage outcome and relationship with urban versus rural context for individuals with psychosis in a population-based study in China. Soc Psychiatry Psychiatr Epidemiol 50, 1501–1509 (2015). https://doi.org/10.1007/s00127-015-1080-8

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    • DOI: https://doi.org/10.1007/s00127-015-1080-8

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