Spouse Depression Research Articles

Physical illness and changes in spousal depression: a register study on Finnish middle-aged couples

Abstract Background Physical health decline may affect family members’ mental health by causing distress and, in case of functional impairments, need to provide care. We examined how diseases common in midlife but with different disease progression and level of impairment are associated with short-term and long-term changes in spousal depression. Methods We used Finnish total population register data from 2000-2019 to identify 91,849 men and 70,836 women aged 30-70 that experienced onset of severe diseases without cognitive impairment (myocardial infarction, prostate cancer, breast cancer), conditions with sudden onset and immediate impairment (stroke, traumatic brain injury) or progressive conditions with increasing impairment (Parkinson's disease, multiple sclerosis, dementia) while living with a spouse. We measured depression with antidepressant purchases and used fixed-effects linear probability models to examine spouses’ depression trajectories before and after onset of spousal disease Results Preliminary findings show that the onset of any type of spousal illness is associated with an increase in depression. Among men this increase is similar in magnitude irrespective of the type of spouse's illness, whereas among women the increase is smaller if the spouse is diagnosed with a disease without cognitive impairment. When the spouse is diagnosed with a progressive condition, female spouses’ depression increases more gradually, whereas a large immediate increase in depression follows sudden onset conditions. One year after diagnosis there are little changes in spousal depression. Conclusions Diseases common in midlife increase spouse's risk of depression around the time of diagnosis, and the effect appears persistent. Adequate support should thus be available to family members from the start of physical illness. When planning support to female spouses, the male spouse's cognitive impairment and associated care needs should be carefully evaluated. Key messages • Diseases common in midlife increase spouse's depression risk around the time of diagnosis, and the effect appears persistent. Support to spouses should be available from the start of illness. • Cognitive impairment of the male spouse seems to increase female spouse's depression particularly strongly, suggesting that caregiving help could be especially beneficial for women.

Husbands' cognitive function was associated with the spouse's depression and contact with their children

Husbands' cognitive function was associated with the spouse's depression and contact with their children

뇌졸중환자와 배우자의 재활회복 경험에 관한 질적 연구

This study used the Qualitative Content Analysis based on the interviews of couples to investigate the factors affecting the rehabilitation motivation of stroke patients. The participants in the Qualitative Content Analysis were 11 couples of the stroke patients and their spouses (22 persons in all). The patients were from four rehabilitation hospitals with more than 100 beds each in Seoul and Gyeonggi-do province. The analysis of the interview data was made using Krippendorff’s content analysis (2003). As a result of the study, ｢patient's depression｣, ｢spouse's depression and burden｣, ｢patient-spouse marital intimacy｣, and ｢patient's rehabilitation motivation｣ were classified into 4 areas, and a total of 11 categories were classified. This can be used as an important factor in the treatment of stroke patients by identifying influencing factors that affect the patient's rehabilitation motivation in the experience of the recovery process of the patient being treated for stroke.

Association between activities of daily living disability and depression symptoms of middle-aged and older Chinese adults and their spouses: A community based study

BackgroundLittle is known about the impact of activities of daily living (ADL) disability on personal and spouse depression symptoms among Chinese. MethodsWe used data from the baseline and 2013 follow-up surveys of the China Health and Retirement Longitudinal Study, a nationally representative survey in 17,708 adults aged 45 years and older, to evaluate cross-sectional and prospective association between ADL disability and depression symptoms of subjects and their spouses. The derived basic ADL scale (BADL) and the Center for Epidemiologic Studies Depression Scale short form were utilized to assess ADL disability and depressive symptoms, respectively. Logistic regression was used to calculate odds ratio (OR) and 95% confidence interval (CI), adjusting for depression risk factors and taking into account the complex survey design and response rate. ResultsThere were 15,890 subjects included in the study. Prevalence of baseline depression symptoms was 29.5% (95%CI 27.9–31.1%), 58.0% (95%CI 54.5–61.4%) and 73.6% (95%CI 70.4–76.8%) in subjects with BADL scores of 0, 1 and ≥2, respectively, and 27.0% (95%CI 25.3–28.7%), 34.2% (95%CI 30.0–38.4%) and 43.8% (95%CI 39.1–48.5%) in subjects without ADL disability while having spouses with BADL scores of 0, 1 and ≥2, respectively. Prospectively, BADL score ≥2 was associated with higher risk of depression symptoms of subjects (OR 1.63, 95% CI 1.03–2.57) and their spouses (OR 1.50, 95% CI 1.01–2.22). LimitationsBias might be introduced because of observational study design, and findings may not be generalizable to younger population. ConclusionsADL disability might have potential to increase risk of depression symptoms of middle-aged and older Chinese adults and their spouses.

Families and Disability Onset: Are Spousal Resources Less Important for Individuals at High Risk of Dementia?

To determine whether social contacts and spousal characteristics predict incident instrumental or basic activities of daily living (I/ADL) limitations and whether effects differ for individuals with high risk of dementia. Cohort study. Biennial interviews of Health and Retirement Study participants over up to 12 years. 4,125 participants aged 65 years and older without baseline I/ADL limitations. Participants' family characteristics (living arrangements, proximity to children, contacts with friends, marital status, and spouse's depression, employment, and education) and dementia probability (high versus low risk of dementia based on direct and proxy cognitive assessments) were characterized at baseline. Family characteristics and their interactions with dementia probability were used to predict incident I/ADL limitations in pooled logistic regressions. ADL limitation incidence was higher among the unmarried (odds ratio [OR] versus married: 1.14; 95% CI: 1.01-1.30); those married to a depressed spouse (OR versus nondepressed spouse: 1.56, 95% CI: 1.21-2.00); or whose spouse had less than high school education (OR versus spouse with high school or more: 1.29, 95% CI: 1.06-1.57). Living with someone other than a spouse compared with living with a spouse predicted higher risk of both incident ADL (OR: 1.35; 95% CI: 1.11-1.65), and IADL (OR: 1.30; 95% CI: 1.06-1.61) limitations. Effects were similar for respondents with high and low dementia probability. Regardless of dementia risk, older adults may receive important marriage benefits, which help delay disability. The salience of spouse's education and depression status implicate modifiable mechanisms, such as information and instrumental support, which may be amenable to interventions.

The Impact of a Spouse's Depression on Family Functioning and Communication

Seung-Hyun Yoo, Hyuk-Ju Kwon, Sun-Hee Kim, Jung-Ah Lee, Sung Sunwoo, Young-Sik Kim, Byung-Su Kim, Han-Jin Oh, Chul-Min Kim, Hee-Jeong Choi, Hee-Jin Hwang, Sun-Wha Ok Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Family Medicine, Vievis Namuh Hospital, Seoul, Korea Department of Family Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea Department of Family Medicine, Eulji University School of Medicine, Daejeon, Korea Department of Family Medicine, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Seoul, Korea Department of Child Development and Family Studies, Institute of Human Ecology, Seoul National University, Seoul, Korea

The effect of the couple's personality similarity on the marital quality

Objective To investigate couple's personality similarity effect on the marital quality, and to explore the vairance of such effect under different levels of spouse's depression. Methods The cross-sectional data of 4644 couple from the national survey of mental health database in china(2009) was used. Couples completed Locke -Wallance marital adjustment test, The CES-D scale a self-report depression scale and Eysenck personality questionnaire short scale for Chinese version (EPQ - RSC). Results The personality similarities of couples(0.44±0.27) and their marital quality (wife (103.71±27.54), husband (106.15±26.94))had significant positive correlation (r=0.25~0.27, P<0.01). Regression analysis showed the effect of personality similarity on the marital quality were varied according to the level of spouse depression(β=0.09-0.22, P<0.05). Among participants whose husband or wife had higher level of depression, couple's personality similarity had stronger effect on his/her perceived marital quality. Conclusion Husband and wife personality similarity is related to marital quality significantly, and the spouse depression plays a significant moderating role in this relationship. Key words: Personality similarity; Marital quality; Spouses' depression

Depressive Symptoms and Rheumatoid Arthritis: Spouse Empathic Responding as a Buffer

To examine the effects of depressive symptoms and spouse empathic responding on patient disability and marital quality over time and to identify factors that contribute to patients perceiving their spouses as responding empathically to their rheumatoid arthritis (RA). Patients diagnosed with RA and their spouses (n = 133 couples) independently completed mailed questionnaires at baseline and 1 year later. Patients completed measures of functional impairment, marital quality, depressive symptoms, and perceived empathic responding from their spouse. Spouses reported their own depressive symptoms and empathic responding behavior. Perceived empathic responding was found to interact with spouse depressive symptoms, contributing significantly to the prediction of patient functional impairment at followup. Only when spouse empathic responding was low was spouse depression associated with greater patient functional impairment 1 year later. Similarly, in the model predicting patient marital quality at followup, there were significant 2-way interactions between perceived empathic responding and both spouse depressive symptoms and patient depressive symptoms. Only when spouse empathic responding was low did patient or spouse depression significantly predict poorer marital quality at followup. Patient perceptions of spouse empathic responding were found to depend on spouse reports of their own empathic responding, patient marital satisfaction, and the interaction of patient depressive symptoms and marital satisfaction. Empathic responding from the spouse was found to buffer against the negative effects of spouse depression on functional and marital outcomes for patients with RA. In developing couple-oriented RA treatments, increasing perceived empathic responding could serve as a useful target for intervention.

Easing Reintegration: Telephone Support Groups for Spouses of Returning Iraq and Afghanistan Service Members

Spouses of returning Iraq (Operation Iraqi Freedom, OIF) and Afghanistan (Operation Enduring Freedom, OEF) military service members report increased depression and anxiety post deployment as they work to reintegrate the family and service member. Reconnecting the family, renegotiating roles that have shifted, reestablishing communication patterns, and dealing with mental health concerns are all tasks that spouses must undertake as part of reintegration. We tested telephone support groups focusing on helping spouses with these basic reintegration tasks. Year-long telephone support groups focused on education, skills building (communication skills, problem solving training, cognitive behavioral techniques, stress management), and support. Spouse depression and anxiety were decreased and perceived social support was increased during the course of the study. In subgroup analyses, spouses with husbands whose injuries caused care difficulties had a positive response to the intervention. However, they were more likely to be depressed, be anxious, and have less social support compared to participants who had husbands who had no injury or whose injury did not cause care difficulty. Study findings suggest that this well-established, high-access intervention can help improve quality of life for military spouses who are struggling with reintegration of the service member and family.

Factors Associated with Poor Sleep Quality in Primary Care

BackgroundSleep disorder is a common problem in adults and affects physical and mental health. We investigated factors associated with poor sleep quality in Korean primary care.MethodsA total of 129 couples (129 husbands and 129 wives) aged 30 to 79 years were included in this study from March, 2009 to February, 2010. The subjects were surveyed using a specific questionnaire. Sleep disorder was defined by a Pittsburgh Sleep Quality Index global score greater than 5 (poor sleepers). The subjects were divided into a group of good sleepers (n = 160) and a group of poor sleepers (n = 98). Socio-demographic and clinical covariates including age, sex, depression, spouse sleep disorder, and spouse depression were reported.ResultsPoor sleep quality was present in 38.0% of total subjects. According to chi-square test results, female, patients with depression, and low sleep quality of spouse were significantly associated with sleep disorder. In multivariate logistic regression analysis, depression increased the risk of poor sleep quality (odds ratio [OR], 7.775; 95% confidence interval [CI], 2.555 to 23.661), and non-risky drinking decreased the risk of poor sleep quality (OR, 0.343; 95% CI, 0.128 to 0.924).ConclusionIn our study, more than one-third of participants had poor sleep quality. Depression was a strong independent factor associated with sleep problems.

Suicidal ideation among HIV+ former blood and/or plasma donors in rural China

Suicidal ideation is life-threatening and is prevalent among people living with HIV (PLWH). A dearth of such studies was conducted in China. This study investigated the prevalence of suicidal ideation and associated factors among PLWH who were former blood and/or plasma donors (FBPD) in a rural county in central China. Prospective respondents were randomly selected from a local registry; 176 PLWH who were FBPD joined the study. With informed consent, these PLWH and their spouse were interviewed separately and anonymously. Respectively, 34 and 8% of the sampled (index) PLWH self-reported having suicidal ideation and making a suicidal attempt in the last year. The multivariate analyses results showed that the index PLWH's Physical Function subscale score of the Medical Outcomes Study HIV Health Survey scale (Odds ratio (OR)=6.67, 95% CI=1.69–26.27, ≤25 percentiles against >75 percentiles), the Depression subscale score of the Depression, Anxiety, and Stress Scales (DASS; OR=9.26, 95% CI=1.32–64.77), and the spouse's Depression subscale score of the DASS (OR=7.64, 95% CI=1.37–42.77) were independently associated with the index PLWH's suicidal ideation. HIV-related variables (e.g., duration of diagnosis, treatment and side effects) and perceived discrimination of the index PLWH, and HIV status of the PLWH's spouse, were not significant factors. Depression is a risk factor for suicides. Moreover, depression may be contagious and the depression status of the spouse also matters. Treatments for depression and prevention intervention for suicides targeting PLWH in rural China are not readily available. Such services are greatly warranted and need to be provided to both the PLWH and his/her spouse.

Spouse depression and disease course among persons with rheumatoid arthritis

To examine the role of spouse mood in the disability and disease course of persons with rheumatoid arthritis (PWRA). A total of 133 married PWRA completed questionnaires, including the Rheumatoid Arthritis Disease Activity Index and the Disabilities of the Arm, Shoulder, and Hand, assessing PWRA arthritis disease activity and disability, respectively, at 2 time points 1 year apart. In addition, both PWRA and their spouses completed the Center for Epidemiologic Studies Depression Scale, a standardized community measure of depression at both time points. Multiple regression analysis revealed spouse depressive symptoms at initial assessment to be predictive of followup PWRA disability and disease activity, even after controlling for initial levels of PWRA depression, disability, disease activity, age, number of years married, education, disease duration, and employment. Specifically, higher levels of spouse depression predicted worse disease course over a 1-year period for PWRA, as indicated by higher reports of subsequent PWRA disability and disease activity. Our findings highlight the key role played by the spouse in PWRA disease course, and point to the importance of including the spouse in clinical interventions. Implications for theory, research, and treatment are discussed with a focus on examining pathways through which spouse depressive symptoms may affect PWRA disease course and disability.

Demonstration of a link between spouse depression and disability and disease activity of persons with rheumatoid arthritis

Demonstration of a link between spouse depression and disability and disease activity of persons with rheumatoid arthritis

Perceived Spouse Responses to Pain: The Level of Agreement in Couple Dyads and the Role of Catastrophizing, Marital Satisfaction, and Depression

The primary objective of this study was to examine whether individuals with chronic pain ("participants") and their spouses agree on perceptions of solicitous, distracting, and punishing spouse responses to pain. The second aim was to examine the role of participant catastrophizing (a negative mental set about pain), participant and spouse marital satisfaction, and participant and spouse depression in participant perceptions of spouse responses, spouse perceptions of their responses, and agreement between participants and spouses. Individuals with chronic musculoskeletal pain and their spouses (N=108 couples) completed questionnaire packets. Examination of overall group averages (participants vs. spouses) indicated little or no differences between participant and spouse ratings. Examination of individual agreement in participant and spouse ratings indicated substantial disagreement. The proposed moderators predicted both participant and spouse perceptions and jointly made minor contributions to dyad agreement. Although neither participant nor spouse perceptions of spouse responses are necessarily a reflection of actual behavior, the lack of agreement in this study suggests it may not be valid to use only patient perceptions in research related to spouse responses.

Chronic stress, depression and immunity in spouses of metastatic breast cancer patients

Objective: The objective of this study was to examine how the chronicity of stress affects psychological stress-responses, depressive symptoms, and in vivo immunocompetence in spouses of women with metastatic breast cancer. Methods: Participants were 34 spouses of breast cancer patients. Their wives had been living with a diagnosis of recurrence metastatic breast cancer for a mean of 2.3 (SD = 3.6) years. Stress chronicity was defined as the length of time since the partner's diagnosis with metastatic breast cancer. Self-reports of psychological stress responses (IES) and depression (CES-D) were taken, and in vivo immunocompetence was assessed by delayed type hypersensitivity (DTH) responses to skin test antigens. Results: Clinically significant levels of depressive symptoms (CES-D > 16) were reported in 15% of participants. Suppression of the DTH response was greater in men who had been living longer with an ill spouse (Spearman r = −0.39, p = 0.011), those who reported more psychological stress (r = 0.37, p = 0.16), and those who had more severe depressive symptoms (r = −0.28, p = 0.054). There was no association between the duration of disease and spouse's depression, however, those who had been living longer with an ill partner reported less psychological stress. Conclusions: This study substantiates a relationship between depression and cell-mediated immunity in spouses with a seriously ill partner. Further, these results suggest that the duration of stress is an important factor of stress-induced immunosuppression. They also highlight the potential importance of interventions to alleviate depression among family members of cancer patients.

When a Parent Has a Stroke

The purpose of this research was to describe the clinical course of children's functioning (depression, behavioral problems, and health status) during the first year after parental stroke and to determine which patient-, spouse-, or child-related factors at the start of inpatient rehabilitation can predict children's functioning after parental stroke at 1-year poststroke. Interviews with 82 children (4 to 18 years of age) and their parents (n=55) shortly after admission to a rehabilitation center, 2 months after discharge from inpatient rehabilitation, and 1 year after stroke. Depression was assessed using the Children Depression Inventory, behavioral problems with the Child Behavior Check List, and health status with the Functional Status II. Potential predictors were gender and age (child), activities of daily living disability and communication ability (patient), and spouse's depression and perception of the marital relationship. At the start of the stroke patient's rehabilitation, 54% of the children had > or =1 subclinical or clinical problems, which improved to 29% 1 year after stroke. Children's functioning 1 year after stroke could best be predicted by their functioning at the start of rehabilitation. Spouse depression and perception of marital relationship were also significant predictors. A total of 28% to 58% of the variance in children's functioning could be explained. Children's functioning after parental stroke improved during the first year after stroke. Identifying children at risk for problems 1 year after stroke requires assessment of children's functioning and the healthy spouse's depressive symptoms and perception of the marital relationship at the start of rehabilitation. This demonstrates the need for a family-centered approach in stroke rehabilitation.

Depression and health‐related quality of life in elderly patients suffering from heart failure and their spouses: a comparative study

Little is known about the factors that influence the health outcome of elderly patients suffering from heart failure or the health of their spouses. The aim of this comparative study was to determine if older patients suffering from heart failure and their spouses experience similar levels of health-related quality of life (HRQOL) and depression. The aim was also to identify those factors that contribute to HRQOL and depression in patient-spouse pairs. Data were collected from 47 couples, using the Short Form 36 (SF-36) and Zung Self-rating Depression Scale (SDS) questionnaires. Patients suffering from heart failure and their spouses differed significantly in their experience of the physical, but not the mental, health-related quality of life, with patients experiencing significantly worse physical functioning. Physical symptoms of heart failure seemed to dominate the experience of the patient and was positively related to mental health and inversely related to the New York Heart Association classification (NYHA class) and patients' depression. Depressive symptoms as reflected in SDS showed no significant difference between patients and spouses. Patients' depression was positively related to high NYHA class, while spouse depression was positively related with higher age of the patient. Physical symptoms seem to dominate the experience of heart failure.

The Longitudinal Effects of Work-Family Conflict and Positive Spillover on Depressive Symptoms Among Dual-Earner Couples.

This study assessed longitudinal and cross-sectional relationships between work-family conflict, positive spillover, and depression in a national sample of 234 dual-earner couples. The authors also assessed crossover effects (i.e., the transmission of emotions, affect, or stress from 1 member of a dyad to another) of work-family conflict and positive spillover on spouses' depression. Two general findings of the study were that (a) positive spillover has a stronger impact on depression than does work-family conflict, and (b) the effects of spouses' positive spillover were more strongly related to decreased depression than were the effects of one's own positive spillover. Significant longitudinal effects were related to the crossover of positive spillover on decreased spouse depression.

Living with heart failure: depression and quality of life in patients and spouses

Background: Although spouses are a key support for patients with heart failure, and help them remain in the community, no one has studied patient–spouse pairs to determine the nature of their experience. Therefore, we conducted a study of patients and spouses to compare their levels of depression and health-related quality of life (HRQOL), and to identify factors that contribute to depression and HRQOL in patient–spouse pairs. Methods: Forty-eight couples, in which all patients were men with heart failure, were recruited from a university-affiliated, outpatient heart failure clinic. Data were collected using the Beck Depression Inventory, the 12-item Short Form (that measures physical and mental components of QOL), and the 6-minute walk test. Results: Patients with heart failure were significantly more depressed and had poorer physical quality of life compared with spouses. Patients’ depression was correlated with their own functional status and mental quality of life, with the combination of 6-minute walk distance and mental QOL contributing 51% of the variance in patient depression. Spouse depression and HRQOL did not significantly influence patient depression. In contrast, spouses’ depression was related to their husbands’ functional status and employment, as well as their own mental QOL. The mental component of spouse QOL and the age of the patient accounted for 33% of the adjusted variance in spousal depression. Conclusions: Patients with heart failure and their spouses experience significantly different levels of depression and physical QOL. In developing interventions, it may be important to take these differences into account and focus on their unique needs as well as those issues that affect the couple together. Interventions that improve patient functional status may result in decreased depression and improved HRQOL on the part of both patients and spouses.

Is it contagious? Affect similarity among spouses

Theories of emotional contagion suggest that spouses mutually experience affective or emotional states. However, empirical support for this theory is limited. Using a dyadic approach, this study examines affect similarity of depressive symptoms between elders with vision impairment and their spouses. As part of an investigation on older couples dealing with disability, 123 elders dealing with a recent vision loss and their spouses were interviewed. Guided by a stress process model, predictors of spouse depressive symptoms were examined. Hierarchical regression analyses revealed that the spouse's race, health, care-giving appraisal, self-efficacy, conflict with other family members regarding their partner, and their partner's depressive symptoms significantly predicted spouse depression. Specifically, spouses who were white, in poorer health, experienced more care-giving burden, had more family conflict, and poorer self-efficacy, were more likely to be depressed. Entered in the final step, elder depression uniquely contributed to the prediction of spouse depression. This points to affect similarity among spouses, which suggests that when one spouse is depressed, the other spouse is likely to experience a similar depressive symptomatology.