Marital interaction and depression

Article Abstract:

Depression and marital distress often accompany one another. In some cases, the depression may be viewed as a result of an unhappy marriage; in other cases, depression may increase the likelihood of marital dissatisfaction. Previous studies have found correlations between unsatisfying marriages and rates of depression in the spouses. To better understand the role that marital interaction may have in depression, four groups of married couples were examined. The groups were as follows: 16 couples with a depressed wife and a distressed marriage; 17 couples with a depressed wife but without a distressed marriage; 18 couples in which neither spouse was depressed, but the marriage was unhappy; and 12 couples that served as a control group in which there was no depression and the marriage was not distressed. The Dyadic Adjustment Scale (DAS) was completed by all spouses and the depressed wives were diagnosed for depression using three criteria: the Beck Depression Inventory (BDI), the criteria for major depression as set forth in the Diagnostic Interview Schedule, and the Hamilton Rating Scale for Depression. Excluded from the study were individuals with other problems such as substance abuse or a history of other mental disorders. Interrelationships were observed between sex of the spouse, level of depression, and marital satisfaction. Combinations of these factors had an interactive effect on rates of aggressive behavior. When the data were reviewed, it was observed that the women who were depressed and who were in nondistressed relationships displayed behavior that was characteristic of unhappy couples, which included high rates of aggression. However, the husbands of the depressed women who were in a nondistressed marriage did not exhibit these traits. Depression did not appear to be a causative factor in unhappy marriages. Regardless of the status of depression, all distressed couples showed the characteristic signs of a negative dysfunctional relationship. The results, along with previous studies, indicate that marital distress, and not depression itself, may be the cause of dysfunctional patterns of interaction so often seen in couples in which one spouse is depressed. In other words, it appears that the depression of the spouse is not to blame for the marital problems. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Complications and side effects, Marital psychotherapy, Couples therapy, Marriage, Married people

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A causal analysis of chronic pain and depression

Article Abstract:

Chronic pain and depression have previously been associated in the literature, but much controversy still exists concerning the causal relationship between these two conditions. One problem in accurately assessing any such relationship is that physical symptoms associated with chronic disease often overlap with depressive symptoms such as insomnia, fatigue, and lethargy. Several hypotheses have been formulated to account for the perceived relationship between chronic pain and depression: depression may cause chronic pain by lowering tolerance thresholds and increasing sensitivity to pain; depression is a secondary reaction to chronic pain; and similar psychological or biological origins may account for depression and chronic pain that occur simultaneously. This study investigated the relationship between these two conditions and the influences they may have on each other. Two self-reported measures of pain were applied to 243 adult patients with diagnosed rheumatoid arthritis, and depressive symptoms were also measured in these individuals. Significantly higher levels of depression were found among these subjects than among individuals who were randomly sampled from the community. The two syndromes were also found to be distinct, but correlated with each other. A direct relationship between pain severity and degree of depression was only moderately evident, although there was some evidence of a causal effect of chronic pain upon depression over longer periods of time; higher correlations between chronic pain and depression were evident in the last 12 months of the study, which suggests that chronic pain is predictive of depression. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Intractable pain

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Characterizing life events as risk factors for depression: the role of fateful loss events

Article Abstract:

Numerous experiments and observations have confirmed that life events and environmental stress can adversely affect mental health. However, characterizing the types of events and relating them to psychopathology is enormously difficult, at least in part because it is hard to categorize into a useful number of groups the broad array of experiences which different individuals may encounter. Some researchers have suggested letting subjects categorize their own experiences in terms of stressfulness, yet this would remove objectivity from the categorization and make it impossible to discern cause and effect relationships between the events and the psychopathology. New methods are being developed to characterize more successfully the role of life events in depression. One factor involved in these new methods is that of the fateful loss. A fateful loss event not only has a negative impact on an individual's life, but it must be completely outside of that individual's control, i.e. an act of 'fate.' Interviews with subjects selected from a neighborhood and from a hospital patient roster were conducted and tallies were made of the subjects' fateful life events. It was found that negative events beyond the individual's control have a demoralizing effect. The design of the study assures that the events did not occur due to any conscious or unconscious influence of the individual involved. An appendix is included describing scales for fateful loss. (Consumer Summary produced by Reliance Medical Information, Inc.)

Stress (Psychology), Loss (Psychology)

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