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Background  Divorce is associated with mental health problems, and heavy drinking is related to higher risk of divorce. Less is known about the effects of divorce in couples where one or both drinks heavily. There are, however, reasons to expect different consequences of divorce in heavy risk using couples compared to other couples. Spouses of abusers may experience the divorce as a relief, whereas abusers may find it extra difficult to be left single. The aim of the study is to compare the effect of divorce on mental health in heavy drinking couples to the effect in couples who drink less.    Methods  Registry data were matched with data from the Nord-Trøndelag Health Study (HUNT 1 (T1) and 2 (T2)), enabling longitudinal analyses of approximately 11,000 couples. Interaction terms between 1) alcohol use on T1 and divorce between T1 and T2 (11 year time lag), and 2) alcohol use on T1 and time since divorce at T2 for all divorced couples were tested to examine changes in mental health between T1 and T2 for a)  spouses  of high-risk compared to low-risk users, and b) high-risk compared to low-risk  users themselves . Data were analyzed using multivariate analysis of variance.    Results  There was a general effect of divorce on change in mental health between T1 and T2. We observed a significantly stronger worsening in mental health in female high-risk users and their spouses than in divorced low-risk users and their spouses. The results also suggest that the strain after divorce lasts longer in women with a high alcohol consumption and their spouses.    Conclusions  Divorce seems to affect couples where one or both drink heavily more than couples with a low consumption. Also there was some evidence of a slower healing of mental health problems after divorce in alcohol exposed couples than in other couples. The results only reached significance for female high consumers and their spouses, but due to limited statistical power, safe conclusions about gender specific effects cannot be drawn.

More mental health problems after divorce in couples with high pre-divorce alcohol consumption than in other divorced couples: results from the HUNT-study