A comparative study of quality of life and marital satisfaction in patients with depression and their spouses

Psychometric properties of dyadic data from the Marital Quality Scale of Indonesian Javanese couples

BACKGROUND

Researchers have demonstrated that various measurement concepts and dimensions depend on context and timing.

OBJECTIVES

The current study aimed to determine the psychometric properties of the Javanese couples' marital quality scale based on validity and reliability METHODS: In total 840 participants or 420 marital dyad from Java, Indonesia, were involved in this study. The psychometrics properties scale was analyzed using exploratory and confirmatory factor analysis, convergent and discriminant analysis, and composite reliability.

RESULTS

The exploratory factor analysis found relationship quality to consist of support, physical proximity, warmth, communication, acceptance and respect, role sharing, and responsibility factors. Well-being quality consists of happiness, harmony, and problem-solving. The fit of the measurement model was obtained using confirmatory factor analysis. The fit model was also found in the husband's and wife's groups, with no differences between them. The high correlations between wife-husband factors also proved the validity based on convergent and discriminant evidence. The reliability coefficient was high for each dimension and construct.

DISCUSSION

This analysis shows that the marital quality scale developed has information on psychometric properties that can be useful for researchers and the practicians using the marital quality instrument of Javanese couples in particular.

Estimation of global rating changes in quality of life and marital satisfaction among reproductive age women in Iran and Afghanistan before and after COVID-19 pandemic

BACKGROUND

Quality of life and marital satisfaction are important components of reproductive-age women's health. This study aimed to compare the quality of life and marital satisfaction in women of reproductive age in Iran and Afghanistan before and after the COVID-19 pandemic.

METHODS

This was a cross-sectional study on a sample of Iranian and Afghan women of reproductive age. To collect the data, the 12-item short-form health survey (SF-12) and the Enrich marital satisfaction scale were used to assess the quality of life and marital satisfaction, respectively. In addition, the Global Rating of Change (GRC) was used in order to evaluate the quality of life and marital satisfaction compared to before the COVID-19 pandemic. Data were evaluated descriptively through statistics including sing t-test, and chi-square, Logistic regression was performed to assess the relationship between outcome variables and independent variables.

RESULTS

In all 599 reproductive-age women (300 Iranian, and 299 Afghan) were studied. After adjusting for demographic variables, no significant difference was observed between the two groups for the physical component (P = 0.05) and mental component summary scores of quality of life (P = 0.166) as measured by the SF-12. The majority of Iranian women reported that their quality of life was worsened compared to before the pandemic (57.2%), while in the Afghan group, a higher percentage declared that it was unchanged (58.9%). The mental component of quality of life had no significant relationship with any of the independent variables including nationality. In contrast, the physical component quality of life had a significant relationship with nationality (P = 0.01). Iranian women had more marital satisfaction than Afghan women (P<0.001) and marital satisfaction had a significant relationship with nationality (P<0.001). Most women in both groups (70% of Iranian and 60% of Afghan women) declared that their marital satisfaction unchanged compared to before the COVID-19 pandemic.

CONCLUSION

The results showed that the quality of life of Iranian and Afghan women of reproductive age was almost the same before and after the pandemic. However, Iranians scored lower on the mental component summary and Afghans reported lower scores on the physical component summary. Marital satisfaction of Afghan women was much lower than that of Iranian women. The findings suggest the need for serious attention by health care authorities. Providing a supportive environment might be considered a primary step towards a better quality of life for these populations.

Spousal concordance in adverse childhood experiences and the association with depressive symptoms in middle-aged and older adults: findings across China, the US, and Europe

Background

Adverse childhood experiences (ACEs) are associated with higher depressive risks in adulthood. Whether respondents' ACEs are associated with their own depressive symptoms in adulthood and whether this association extends to their spouses' depressive symptoms remain unexplored.

Methods

Data were from China Health and Retirement Longitudinal Study (CHARLS), the Health and Retirement Study (HRS), and the Survey of Health, Ageing and Retirement in Europe (SHARE). ACEs were categorized into overall, intra-familial, and extra-familial ACEs. Correlations of couples' ACEs were calculated using Cramer's V and partial Spearman's correlation. Associations of respondents' ACEs with spousal depressive symptoms were assessed using logistic regression, and mediation analyses were conducted to explore the mediating role of respondents' depressive symptoms.

Results

Significant associations between husbands' ACEs and wives' depressive symptoms, with odds ratios (ORs) and 95% confidence intervals (CIs) of 2.09 (1.36-3.22) for 4 or more ACEs in CHARLS, and 1.25 (1.06-1.48) and 1.38 (1.06-1.79) for 2 or more ACEs in HRS and SHARE. However, wives' ACEs were associated with husbands' depressive symptoms only in CHARLS and SHARE. Findings in intra-familial and extra-familial ACEs were consistent with our main results. Additionally, respondents' depressive symptoms mediated more than 20% of the effect of respondents' ACEs on spousal depressive symptoms.

Conclusion

We found that ACEs were significantly correlated between couples. Respondents' ACEs were associated with spousal depressive symptoms, with respondents' depressive symptoms mediating the association. The bidirectional implications of ACEs on depressive symptoms should be considered within household and effective interventions are warranted.

Differences in cognitive functions of atypical and non-atypical depression based on propensity score matching

BACKGROUND

Clinical and etiological heterogeneity have hindered our understanding of depression, thus driving the studies of major depressive disorder (MDD) subtypes. Atypical depression (AD) is a subtype of MDD with atypical features. Cognitive impairment is one of the factors that contribute to the suffering of patients with MDD. Therefore, this study investigated the characteristics and differences in cognitive functioning of AD and non-atypical depression (non-AD) using the MATRICS Consensus Cognitive Battery (MCCB).

METHODS

A total of 101 patients with AD and 252 patients with non-AD were assessed with the MCCB and clinical scales. Propensity score matching (PSM) was used to balance confounders between groups. After PSM, between-group differences were compared for cognitive and clinical variables. In addition, multiple linear regression analyses were performed to explore the effects of cognitive and clinical variables on the quality of life.

RESULTS

The AD group scored significantly lower in attention/vigilance and social cognition in all cognitive domains than the non-AD group. Attention/vigilance and social cognition were significant positive predictors of quality of life, whereas atypical symptoms and depressive severity were significant negative predictors.

CONCLUSIONS

This study suggests significant differences in cognitive functions between the AD and non-AD subtypes. Atypical symptoms and impaired cognition have a negative impact on patients' quality of life. Attention/vigilance and social cognition are worse in AD than non-AD, which the atypical features of patients with AD may explain. The pathological mechanisms and treatment strategies of AD should be further explored in the future to promote individualized treatment strategies.

A Dyadic Investigation of Relationship Dynamics and Depressive Symptoms in HIV-Affected Couples in Malawi

Depression is the leading cause of disability worldwide with health implications for people living with HIV. Primary partnerships like marriage could be protective against depression but may worsen depression depending on the relationship quality. We examined depression and its association with relationship dynamics in a cross-sectional sample of 211 HIV-affected married couples in Malawi. We fit multivariable multilevel linear regression models for depressive symptoms. Men and women reported similar levels of depressive symptoms; 28% had a score indicative of probable depression. Almost half of couples had at least one partner with probable depression. In the adjusted models, equality (B = - 0.22; p < 0.01) and unity (B = - 0.94; p < 0.05) were associated with fewer depressive symptoms while individuals with more experiences of physical (B = 0.81; p < 0.01), sexual (B = 0.87; p < 0.01), and emotional violence (B = 1.52; p < 0.001) had higher levels of depressive symptoms. Couples-based interventions aiming to improve relationships may address depression, especially in settings with inadequate mental health services.

Effect of marital relationship on women's quality of life: Testing the mediating role of subjective well-being

Because of a large number of Chinese women and the widespread concern about women's living conditions, this study aimed to examine how subjective well-being mediates the association between marital relationship and women's quality of life in Chinese context. The data used in this study were collected by conducting a multi-stage cluster random sampling method of 756 women in Huai'an city of Mainland China. Data included women's basic demographics, women's quality of life and marital quality, and women's subjective well-being. Structural equation modeling was adopted to analyze the data. The results of structural equation modeling analysis suggested a good fit for the sample. Overall findings showed that marital relationship has a significantly direct effect on women's quality of life, and subjective well-being can partially mediate the impact of marital relationship on women's quality of life. The implications on theory and social policy were also discussed.