PSYCHIATRIC ILLNESS IN THE PHYSICIAN'S WIFE

The psychiatrist's family--a comparative study

The results of a questionnaire survey of the partners of psychiatrists and general practitioners are presented. The questionnaire was designed to elicit feelings about the respective professions. Methodological issues are discussed, and the wisdom of comparing different medical groups is questioned. Although significantly fewer psychiatrists' partners initially had positive feelings towards their spouse's career, the majority of both groups reported currently positive feelings. Only a minority, and in equal proportions in the two groups, reported that their spouse's profession had interfered with their relationships with friends or had influenced their marital relationship. A significantly greater number of general practitioners' partners reported that their spouse's profession was more stressful than that of other professionals. The results also indicated that a significantly greater number of psychiatrists than general practitioners as perceived by their partners as using psychiatric interpretation and jargon in the family setting. Furthermore, the comments provided, although representative of only a minority of respondents, demonstrated that this could provide a unique stress for the families of some psychiatrists.

The physician's work and marriage

Medicine and personality characteristics of its practitioners pose for physicians unique hazards to emotional health and marital satisfaction. The attempt to meet too many emotional needs in work may preclude adequate attention to personal and family problems. The physician should be more aware of his own and his family's emotional needs, and be less threatened by less-than-perfect adjustment in himself or other family members. Suggestions include: teaching psychiatry on a developmental and adaptational model; offering marital groups in medical school; and encouraging the process of marital contracting and the use of marital therapy when emotional problems arise in either spouse. The understanding and resolution of emotional distress of one marital partner often requires the involvement of both, as people intimately attached to each other tend to have neither problems nor solutions in isolation.

The doctor's wife

A sociological survey of 52 doctors' wives was performed. The majority had attended private school, 19% had reached a tertiary level of education and 58% had been employed in the health profession before marriage, 42% in the nursing profession. At the time of the survey only 10% were in full-time external employment, but the majority assisted their husbands in their professional work. A minority acknowledged some loss of personal identity in being a doctor's wife.

The doctor's wife: mental illness and marital pattern

It is a clinical impression that physicians' wives present in disproportionately large numbers as psychiatric patients; that in the vast majority severe marital problems are present; and that the marital relationships show a similar pattern. The purpose of this paper is to ascertain whether the latter two impressions have any basis in fact. Accordingly, a random sample of twenty physicians' wives who had been in-patients in the University of British Columbia Health Sciences Centre Hospital during the period March 1, 1969 to May 31, 1973, and whose husbands had been interviewed, was selected. The records were reviewed to obtain personal data, pertinent psychiatric history, diagnosis, the personality of husband and wife and information on the marital relationship. These conclusions emerged: 1. Ninety per cent of the patients had a primary diagnosis of depressive neurosis. 2. Ninety-five per cent of the patients had a secondary diagnosis of personality disorder, hysterical personality and passive-aggressive personality in order of frequency. 3. In 90 per cent of the patients there was a history of suicidal preoccupation or attempt. 4. In 55 per cent of the patients there was a history of significant drug and/or alcohol abuse. 5. The patients were more frequently ward management problems. 6. A common marital pattern was noted: a dependent, histrionic wife and an emotionally detached husband. 7. The cases were characterized by their complexity, severity, long duration and difficulties involving the patient and spouse in an appropriate treatment plan. The authors discuss the implications of this study, particularly its significance in provoking examination of what measures might be utilized for early detection and intervention with those physicians and physician-marriages at risk.

Psychiatric illness in the medical profession

In view of the important implications of the subject, it is surprising that there have been so few studies of psychiatric illness within the medical profession, except specifically in regard to drug addiction. Indeed, we could find only two papers on the overall psychiatric morbidity in the profession published during the last decade (Duffy and Litin, 1964; Pearson and Streker, 1960). In Great Britain there have been no published studies of this kind as far as we can discover.