Several studies suggest that spouses significantly resemble each other in their risk of alcohol use disorder (AUD); however, the exact cause of this association is not known. This study aims to examine the association of AUD in one spouse with the risk of AUD in the other.

This population-wide analysis included a total of 8,562 married pairs (5883 female probands and 2679 male probands) of mean (SD) age 29.9 years at marriage. The marital pairs had no history of AUD before marriage, and the first spouse registered AUD during the marriage. A total of 4,891 individuals with multiple marriages whose first spouse had no AUD but second spouse did (or vice versa) were also included. The primary outcome of the study was AUD registration.

Of the 8,562 marital pairs, the hazard ratio (HR) of AUD registration in wives immediately after AUD registration in husbands was 13.82, which alleviated to 3.75 within 2 years. The HR of AUD registration in husbands after the registration in wives was 9.21, which reduced to 3.09 two years later. 

The findings suggested that the risk of AUD registration in a married individual post AUD registration in the spouse is large. The risk, however, alleviated substantially within 2 years.