One third of Indians consume alcohol and there is an alarming annual increase in alcohol consumption.⁽¹⁾ A recent WHO report also states, there is an annual increase in global alcohol consumption.⁽²⁾ Heavy drinking is more common in men, in lower socio- economic groups, in those with lower educational levels and in the young.⁽³⁾ Majority of spouses of alcohol dependent males are also the primary care-takers of their husbands and are at risk of domestic violence. ⁽⁴⁾ Marital dissatisfaction and maladjustment reduce their involvement in getting their husbands treated for alcohol dependence.⁽⁵⁾

This cross – sectional study was conducted on spouses of two hundred consecutive males with alcohol dependence syndrome attending the psychiatry department of a tertiary care medical college hospital in Kanchipuram District in Tamilnadu after obtaining the institutional ethical committee approval and written informed consent from participants. Males (≥18 years of age) fulfilling the diagnostic criteria for alcohol dependence according to ICD 10 and their spouses who offered consent to participate in the study were included. Spouses with major physical illness or unable to accompany the husband with alcohol dependence syndrome to the psychiatry department and those not offering consent to participate in the study were excluded. Socio-demographic profile was obtained using a semi-structured proforma. Severity of alcohol dependence in male alcoholics was assessed using Short-form Alcohol Dependence Data (SADD). Marital satisfaction among spouses was assessed using ENRICH Marital Satisfaction (EMS) Scale.

In our study, the age distribution among alcohol dependent male patients and their wives was highest in 31 to 40 years age group. They constituted around 36% and 43% of the study population. This result is similar in a study done by Dandu et al where majority of wives of alcohol dependent males were in age group between 31 to 40 years.⁽⁴⁾ Sarkar et al in their study from eastern India also found that majority of the alcohol dependent cases were from the age group of 20 49 years (85%). ⁽⁵⁾ A study from Bangalore, India found preponderance of the alcoholic cases in the age range of 20 50 years. ⁽⁶⁾ Another study by Soni et al also had the mean age of alcohol dependent men as 32 ± 7.2 and that of controls 34 ± 5.8.⁽⁷⁾

Observations from our study revealed that majority comprising, 83.5% of both alcohol dependent men and their spouse had completed only their primary schooling. Similar results were noted by Ghosh P et al where 60.86 % of spouses of alcohol dependent men were educated only up to the primary level.⁽⁸⁾ Studies done by Sarkar et al and Soni et al observed that majority of alcohol dependent men had completed their primary schooling only.^(5,7) Around 50 % of wives of alcohol dependent men were home makers (unemployed) in our study. According to Ghosh P et al and Bagul, 78.26 % and 68.3 % respectively of spouses of alcohol dependent men were unemployed in their study.^(8,9) In our study, majority of men earned between Rs.5000 to 10,000 and most of them were unskilled workers. This is similar to previous studies where most of the alcohol dependent men were unskilled workers (37.68 %, 76 % and 55 % respectively).^(5,7,9)

In our study, on administering SADD to measure the severity of alcohol dependence, mean score obtained was 25.05 ± 8.891, indicating significant dependence. 13% of patients had low, 13% had medium and 74% had high dependence in our study. This is similar to a study done by Soni et al where on administering SADD, the mean score found was 24.86 ± 10.1, indicating significant dependence in alcohol dependent men, 46 % of them were found to be moderately dependent on alcohol consumption, while 42 % were severely dependent according to SADD scores.⁽⁷⁾ Also, another study done by Bagul et al where SADD scores were administered, SADD scores ranged from 4 45 and mean score was 20.35. Severity of alcohol dependence on SADD in males with alcohol dependence suggested significant dependence. Almost equal numbers of alcohol dependent males were found in the moderate and high dependence range.⁽⁹⁾

The scores on ENRICH marital satisfaction scale (EMS) were in range of 14 to 60. The mean EMS score was 31.76. Majority of the scores were in the lower range indicating lesser degree of marital satisfaction. All wives of those with low dependence scores reported higher satisfaction. This is similar to a study done by Kishore et al where the marital satisfaction scores were in the range from 1 57 and almost all of the spouses had scores at the lower end of the scale indicating lower degree of marital dissatisfaction (mean 26.7 ± 12.8). Also, marital satisfaction scores decreased as severity of dependence increased. Hence he concluded that the severity of alcohol dependence obtained from SADD scores was strongly associated with marital dissatisfaction in the spouses.⁽¹⁰⁾

In a study done by Vimala et al, marital satisfaction was negatively correlated with severity of alcohol dependence thereby concluding that spouses of alcohol dependent men had lower levels of satisfaction.⁽¹¹⁾

In our study, among all wives who reported lower marital satisfaction, 95 % of husbands had high dependence scores. This study concludes that alcohol dependence in men can significantly impact on the quality of marital life among the spouses.

This is a hospital based study, at risk of recruitment bias. Marital satisfaction was based on self-report only. The study only had a cross sectional design and follow up of the participants would have been useful to find out if successful treatment improves marital satisfaction. More research involving a larger community based sample is required to corroborate the findings of our study.