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Ba ckground: Alcohol use disorder (AUD) affects not only an individual’s health but also their family. Thisstudy was conducted to examine effects of a spouse’s AUD on family functioning and family communication. Me thods: We conducted a cross-sectional study using data from 890 participants (445 couples) in a Koreanfamily cohort in primary care. Participants with Alcohol Use Disorders Identification Test in Koreascores of 8 or greater were classified into an AUD group. Family functioning was classified into threegroups (balanced, midrange, and extreme) using the Family Adaptability and Cohesion Scale (FACES)-III questionnaire, and then reclassified into two groups (appropriate and extreme groups) for binominalanalyses. Family communication was classified into three groups (high, moderate, and low) using theFamily Communication Scale, FACES-IV, and also reclassified into two groups (good and poor). Re sults: There was no significant difference in adaptability and cohesion between both male and femaleparticipants with a spouse with AUD and participants with a spouse without AUD. Using multivariatelogistic regression to adjust for potential confounders, there was no significant difference in family typeand communication between the two groups in males. However, there was a significant decrease in familycommunication (odds ratio, 2.14; 95% confidence interval, 1.29 to 3.58) in females with a spouse with AUDcompared to females with a spouse without AUD, even after adjusting for the participant’s own AUD. Co nclusion: In females, family communication is significantly worse when spouses have AUD. Thissuggests that a husband’s alcohol consumption has negative effects on his wife’s family communication.

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