Multiple Chronic Conditions, Spouse's Depressive Symptoms, and Gender within Marriage

Network analysis of the urban-rural differences in depressive symptoms among older adults with multiple chronic conditions: Evidence from a national survey

BACKGROUND

Evidence on the differences in depressive symptoms among older adults with multiple chronic conditions (MCCs) in urban and rural areas is limited.

METHODS

Measures of depressive symptoms (Center for Epidemiologic Studies Depression Scale-10) and demographic factors (age, gender, and urban-rural distribution) were used.

RESULTS

A total of 4021 older adults with MCCs were included in this study. Significant differences were observed in both network global strength (Urban: 3.989 vs. Rural: 3.703, S = 0.286, p = 0.003) and network structure (M = 0.139, p = 0.002) between urban and rural residents.

CONCLUSIONS

The study highlights the need for region-specific approaches to understanding and addressing depression and holds the potential to enhance understanding of the psychological health status of older adults with MCCs in urban and rural settings.

Spousal health, marital satisfaction, and older Chinese adults' sleep: The moderating role of psychological resilience

PURPOSES

This study aims to examine the moderating role of psychological resilience in the association between two common marital relationship stressors (poor spousal health and low marital satisfaction) and sleep (sleep quality and sleep duration) among older adults in China.

METHODS

This study used four waves of data from the Chinese Longitudinal Healthy Longevity Survey (2008-2018) (N = 8769), and mixed-effects logistic models were used.

RESULTS

Poor spousal health and low marital satisfaction were independently associated with increased odds of poor sleep quality and short sleep duration, and decreased odds of long sleep duration. Greater psychological resilience was associated with increased odds of good sleep quality and decreased odds of short sleep duration, but had no significant effect on long sleep duration. In addition, psychological resilience moderated the odds of poor spousal health and low marital satisfaction on the risk of short sleep duration among older Chinese adults.

CONCLUSION

The findings provide novel evidence for the increased importance of marital stress and psychological resilience on sleep health in later life. Policy interventions are needed to support vulnerable older adults who experience poor spousal health and/or low marital satisfaction.

Analysis of current situation and influencing factors of marital adjustment in patients with Crohn's disease and their spouses

The purpose of this study was to investigate the marital adjustment of patients with Crohn's disease and their spouses, and to analyze its influencing factors. It lays the investigation foundation for the follow-up binary study of Crohn's disease patients and their spouses. Using convenience sampling, 177 pairs of patients and their spouses from a tertiary hospital in Nanjing, China were selected. With face-to-face electronic questionnaires to survey the patient and spouse, the contents include the Lock-Wollance Marriage Adjustment Test, Subjective Well-Being Scale for Chinese Citizens, Couple Support Questionnaire, and Distress Self-Disclosure Scale. The marital adjustment score of patients was (99.03 ± 24.25), and the marital adjustment score of spouses was (99.61 ± 25.39). The proportions of patients with marital disorders and their spouses with marital disorders were 52.5% and 46.9%, respectively. Multiple linear regression showed that the spouse's age, family monthly income, time of diagnosis of Crohn's, distress self-disclosure, marital support, and subjective well-being were important factors influencing the marital adjustment of patients. Self-disclosure of spousal distress, marital support, age, and subjective well-being were important factors that influenced spouses' marital adjustment. Most couples with Crohn's disease have marital disorders, and their marital adjustment affects each other. However, the assessment results of one partner should not be limited to replacing those of the couple. In clinical practice, patient age, monthly family income, self-disclosure of distress, marital support, and subjective well-being should be considered. Spouses should be encouraged to participate in patient care and patient-spouse interventions should be implemented as a whole to improve marital stability.

Neurological conditions and subsequent divorce risk in the Nordic countries: the importance of gender and both spouses' education

BACKGROUND

Prior studies suggest that poor physical health, accompanied by functional disability, is associated with increased divorce risk. However, this association may depend on gender, the socioeconomic resources of the couple, as well as the social policy and social (in)equality context in which the illness is experienced. This study focuses on neurological conditions, which often have substantial functional consequences.

METHODS

We used longitudinal population-wide register data from the years 2007-2016 (Denmark, Sweden) or 2008-2017 (Finland, Norway) to follow 2 809 209 married couples aged 30-64 for neurological conditions, identified using information on specialised healthcare for diseases of the nervous system and subsequent divorce. Cox regression models were estimated in each country, and meta-analysis used to calculate across-country estimates.

RESULTS

During the 10-year follow-up period, 22.2% of couples experienced neurological conditions and 12.0% of marriages ended in divorce. In all countries, divorce risk was elevated among couples where at least one spouse had a neurological condition, and especially so if both spouses were ill. The divorce risk was either larger or similar for husband's illness, compared with wife's illness, in all educational categories. For the countries pooled, the weighted average HR was 1.21 (95% CI 1.20 to 1.23) for wives' illness, 1.27 (95% CI 1.25 to 1.29) for husbands' illness and 1.38 (95% CI 1.34 to 1.42) for couples where both spouses were ill.

CONCLUSIONS

Despite some variation by educational resources and country context, the results suggest that the social consequences of illness are noticeable even in Nordic welfare states, with the husband's illness being at least as important as the wife's.

Spousal multimorbidity and depressive symptoms among older Indian couples: Do one's own health status and sex matter?

With the aging population, increases in non-communicable diseases that require chronic management pose a substantial economic and social burden to individuals with multimorbid conditions and their spousal caregivers. However, little is known about the crossover effect of spousal multimorbidity on mental health outcomes in the context of low- and middle-income countries, and whether it depends on one's own health status and sex. We examined the association between spousal multimorbidity and depressive symptoms using data on 6,158 older couples (12,316 individuals aged 60 years or above) from the Longitudinal Aging Study in India (LASI) 2017-18. Overall, 23.4% of the sample were multimorbid and 27.0% reported having depressive symptoms in the past week. Multivariable logistic regression models showed that spousal multimorbidity was associated with depressive symptoms, even after accounting for one's own multimorbidity status (OR: 1.23; 95% CI: 1.06-1.44). However, this association varied by sex. Among males, their own multimorbidity status was associated with 60% higher odds of having depressive symptoms (OR: 1.60; 95% CI: 1.28-2.00), but spousal multimorbidity was not. Furthermore, for males, the association between spousal multimorbidity and depressive symptoms was contingent upon the presence of their own multimorbidity. Among females, spousal multimorbidity was significantly associated with depressive symptoms, regardless of their own multimorbidity status. Our findings indicate that interventions to promote healthy aging should expand the formal caregiving system and consider family-based approaches to minimize the crossover health consequences of chronic morbidity in conjugal relationships, especially for females.

Hospitalization's association with depression in adults over 50 years old: does living arrangement matter? Findings from the Health and Retirement Study

OBJECTIVES

To examine how living arrangements are associated with depressive symptoms in late middle-life and older adults following hospitalization within the last two years.

DESIGN

We used the 2016 wave of the Health and Retirement Study (HRS), a nationally representative survey of adults over 50 years old living in the United States.

METHODS

The dependent variable was whether HRS participants screened positive for having depressive symptoms. The primary independent variable was self-reported hospitalization in the prior two years. We stratified bivariate analyses and multivariate logistic regressions by living arrangement to examine hospitalizations' association with depressive symptoms.

RESULTS

Depressive symptoms were less prevalent among participants who were married or partnered and living with a partner (14.0%) compared to those who were not married or partnered and were living with others (31.7%) and were not married or partnered and were living alone (27.8%). In multivariate analyses stratified by living arrangement, however, hospitalization was associated with depressive symptoms for those married or partnered and living with a partner (OR = 1.39, 95% CI: 1.14-1.69) but not for those who were not married and living with other(s) (OR = 0.88, 95% CI: 0.65-1.18) and not married or partnered and living alone (OR = 1.06, 95% CI: 0.82-1.36).

CONCLUSIONS

Late middle-life and older adults residing with spouses or cohabitating appear at risk for having depressive symptoms following a hospitalization. A better understanding of how relationships and living arrangements may affect depression risk in the context of an acute medical illness is needed to identify points of intervention.

Association Between Multiple Chronic Conditions and Depressive Symptoms Among Older Adults in China: Evidence From the China Health and Retirement Longitudinal Study (CHARLS)

Objectives: The purpose of this study was to explore the association between multiple chronic conditions (MCCs) and depressive symptoms among older adults in China. Methods: We used the fourth round of data from the China Health and Retirement Longitudinal Study, and included 9789 older adults aged 60 years old and above. Results: Compared with the older adults without chronic disease, older adults with MCCs and those with one chronic disease had a high risk of depression (MCCs: OR_-adjusted: 1.55, 95% CI: 1.37 to 1.75; one chronic disease: OR_-adjusted: 1.20, 95% CI: 1.05-1.37). In urban areas, the prevalence among older adults with MCCs was 2.01 times higher than that among older adults without chronic disease (OR_-adjusted: 2.01, 95% CI: 1.56-2.60), while it was 1.44 times higher in rural areas (OR_-adjusted:1.44, 95% CI: 1.25-1.65). Self-reported health, duration of sleep, social activities, and type of medical insurance were the influencing factors of depressive symptoms in older adults. Conclusion: This study contributed to enriching the research on the relationship between MCCs and depressive symptoms in older adults in China.

The Intersecting Consequences of Race-Gender Health Disparities on Workforce Engagement for Older Workers: An Examination of Physical and Mental Health

The dramatic growth of older adults' labor participation over the past 25 years, including women and people of color, is reshaping the American labor force. The current study contributes new knowledge concerning why individuals over age 50 years may be working longer despite negative impacts of deteriorating physical and mental health associated with aging. Inquiries regarding who continues to work and why can be answered, in part, by addressing how workforce engagement and health are shaped by notable social inequities along the dimensions of age, race, and gender. Guided by cumulative advantage/disadvantage and intersectionality frameworks, we examine whether having multiple chronic conditions (MCC)-two or more physical conditions-and depression affect workforce participation. Using multinomial logistic regression models, we analyze the 2014-2016 waves of the Health and Retirement Study (N = 4250). Findings reveal that having multiple chronic illnesses increase the likelihood of labor force exit, especially among workers who also have depression. We also discover intersectional nuances which illuminate complex race-gender dynamics related to health and work processes in later life. We conclude with recommendations for workplace policy that promote the retention of older workers with chronic illness and depression and aim to decrease disparities in older workers' work engagement.

Effect and quality of couple-based interventions of middle-aged and older adults with type 2 diabetes mellitus: a scoping review

BACKGROUND

Studies have shown the existence of health concordance between patients with type 2 diabetes mellitus (T2DM) and their spouses, and also that spouses could influence the effect of self-management, benefiting patients' health. However, these studies are heterogeneous and the evidence is inconclusive.

OBJECTIVE

To synthesize evidence from published randomized controlled trials: the interventional effects and the quality of study performance, also to identify the research gap and the directions for future studies.

METHODS

We performed the scoping review by following the PRISMA-ScR guidance. We searched and examined the reports from MEDLINE, EMBASE, PsychInfo, CINAHL Plus by the pre-specified criteria. Key characteristics and information of eligible reports were extracted, analysed and synthesized comprehensively, and the results were presented in the form of words and diagrams.

RESULTS

We identified 5 reports from 4 studies out of 3479 records included. Qualified studies indicated a positive effect of couple-based interventions on couples' distress. Insufficient evidence on physiological health or health behaviours was identified owing to the small number of included studies and inconsistent assessment outcomes. The methodological quality across these studies was generally low due to inadequate reporting of study process and substantial biases.

CONCLUSIONS

Couple-based interventions for patients with T2DM showed small effects on the couple's distress while the effects of other outcomes were inconclusive. Future studies should strengthen methodologies by using standard measures of core diabetic outcomes, including detailed assessments of implementation process, and taking a dyadic approach to systematically examine the effects.

The Association between Multiple Chronic Conditions and Depressive Symptoms: Intersectional Distinctions by Race, Nativity, and Gender

Using random coefficient growth curve analysis, this study utilizes 12 waves of data from the Health and Retirement Study (1994-2016; person-waves = 145,177) to examine the association between multiple chronic conditions (MCC) and depressive symptoms among older adults. Applying cumulative disadvantage and intersectionality theories, we also test whether the association between MCC and depressive symptoms differs by race, nativity, and gender. Findings reveal that MCC prevalence is highest among U.S.-born black women, whereas depressive symptoms are highest among foreign-born Hispanic women. Compared to men, MCC has a stronger effect on women's depressive symptoms. Furthermore, the MCC-depressive symptoms association is strongest for foreign-born Hispanic women. Despite an increase in MCC in the transition from midlife to late life, all race-nativity-gender groups experience a decline in depressive symptoms as they age. The decline in depressive symptoms is steepest for U.S.-born black and foreign-born Hispanic women. Study implications are discussed.

Discordant Chronic Conditions and Depressive Symptoms: Longitudinal Associations Among Middle-Aged and Older Couples

OBJECTIVES

Individuals often manage chronic conditions in middle and later life that may diminish well-being. Little is known, however, about discordant conditions (i.e., two or more conditions with competing self-management requirements) among older couples and their links to depressive symptoms. We considered discordant conditions at both the individual level and the couple level (i.e., between spouses), along with their long-term implications for depressive symptoms.

METHODS

The U.S. sample included 1,116 middle-aged and older couples drawn from five waves (2006-2014) of the Health and Retirement Study. Longitudinal actor-partner interdependence models evaluated whether individual-level and couple-level discordant chronic health conditions were concurrently linked to depressive symptoms, and whether these associations became stronger over time. Models controlled for age, minority status, education, prior wave depressive symptoms, and each partner's baseline report of negative marital quality and number of chronic conditions in each wave.

RESULTS

Wives and husbands reported significantly greater depressive symptoms when they had individual-level discordant conditions about 2 years after baseline, and these links intensified over time. Beyond this association, husbands had significantly greater depressive symptoms when there were couple-level discordant conditions.

DISCUSSION

Individual-level and couple-level discordant conditions may have lasting implications for depressive symptoms during midlife and older adulthood.

Individual-Level and Couple-Level Discordant Chronic Conditions: Longitudinal Links to Functional Disability

BACKGROUND

Multiple chronic conditions may erode physical functioning, particularly in the context of complex self-management demands and depressive symptoms. Yet, little is known about how discordant conditions (i.e., those with management requirements that are not directly related and increase care complexity) among couples are linked to functional disability.

PURPOSE

We evaluated own and partner individual-level discordant conditions (i.e., discordant conditions within individuals) and couple-level discordant conditions (i.e., discordant conditions between spouses), and their links to levels of and change in functional disability.

METHODS

The U.S. sample included 3,991 couples drawn from nine waves (1998-2014) of the Health and Retirement Study. Dyadic growth curve models determined how individual-level and couple-level discordant conditions were linked to functional disability over time, and whether depressive symptoms moderated these links. Models controlled for age, minority status, education, each partner's baseline depressive symptoms, and each partner's number of chronic conditions across waves.

RESULTS

Wives and husbands had higher initial disability when they had their own discordant conditions and when there were couple-level discordant conditions. Husbands also reported higher initial disability when wives had discordant conditions. Wives had a slower rate of increase in disability when there were couple-level discordant conditions. Depressive symptoms moderated links between disability and discordant conditions at the individual and couple levels.

CONCLUSIONS

Discordant chronic conditions within couples have enduring links to disability that partly vary by gender and depressive symptoms. These findings generate valuable information for interventions to maintain the well-being of couples managing complex health challenges.

Aging, care and dependency in multimorbidity: how do relationships affect older Bangladeshi women's use of homecare and health services?

Gender issues can create major barriers to healthcare utilization for older women with multimorbidity, especially in developing countries like Bangladesh. Elderly rural women in Bangladesh, are the poorest of the poor, and the women with multimorbidity live in a regulated family atmosphere. This study explored the relationship dimensions of older women with multimorbidity in homecare and their utilization of health services. To gain a deeper understanding of these complex issues, a qualitative case study was conducted. Semi-structured, in-depth interviews were conducted with 11 health staff and 22 older women with multimorbidity, living in three residential communities of the Sylhet District, Bangladesh. Our analysis used critical thematic discourse, a technique developed from Axel Honneth's recognition-and-misrecognition theory. Seven relationship dimensions have been identified, and grouped under three major themes: intimate affairs [marital marginalization and parent-children-in law dynamics]; alienation in community relationships [patriarchal sibling relationships, neighborhood challenges, and gender inequality in interactions]; and legal disconnections [ignorance of rights and missed communication]. Our findings revealed a lack of understanding of the women's multimorbid care needs and patriarchal marginalization in family. This lack of understanding together with poor peer-supports in healthcare is perpetuated by misrecognition of needs from service providers, resulting in a lack of quality and poor utilization of homecare and health services. Understanding the high needs of multimorbidity and complexities of older women's relationships can assist in policy decisions. This study deepens our understanding of the ways gender inequality intersects with cultural devaluation to reduce the well-being of older women in developing countries.

Gender Specificity of Spousal Concordance in the Development of Chronic Disease among Middle-Aged and Older Chinese Couples: A Prospective Dyadic Analysis

This study aimed to explore the gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older Chinese couples. Data of 3420 couples were obtained from the China Health and Retirement Longitudinal Study (CHARLS). Multivariate logistic regression was used to analyze the incidence of chronic disease development over 4 years, conditional on the spousal baseline chronic disease status; and stepwise adjusting for the couples’ sociodemographic characteristics (i.e., age, education, retirement status and household income), and their individual lifestyle (i.e., smoking, drinking, exercise, social participation and BMI) all measured at baseline. The incidence of chronic diseases after 4 years of follow-up was 22.95% in the husbands (605/2636) and 24.71% in the wives (623/2521). Taking the couples’ baseline sociodemographic and lifestyle covariates into account, husbands whose wife had chronic diseases at baseline showed an increased risk of developing chronic diseases over 4 years (OR_adjusted = 1.24, 95%CI: 1.02, 1.51), but this risk was not statistically-significant for wives (OR_adjusted = 0.88, 95%CI: 0.71, 1.08). Our study identified gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older Chinese couples. This finding may contribute to the design of couple-based intervention for disease prevention and management for community-dwelling older adults.

Marital Stability and Quality of Couple Relationships after Acquired Brain Injury: A Two-Year Follow-Up Clinical Study

Couple relationships after acquired brain injury (ABI) could be vulnerable to emotional distress. Previous evidence has demonstrated significant marital dissatisfaction in the first period after a traumatic event, while long-term evaluations are lacking. In this study, we evaluated the impact of a series of demographic and clinical factors on marital stability after two years from the injury. Thirty-five patients (29% female) with mild/moderate ABI (57% vascular, 43% traumatic) and their partners were enrolled. The couples completed a series of psychological questionnaires assessing marital adjustment (Dyadic Adjustment Scale, DAS) and family functioning (Family Relationship Index, FRI) at discharge from the intensive rehabilitation unit and after 2 years. Demographics (i.e., educational level, job employment and religion commitment) and clinical variables (i.e., the Barthel index, aetiology and brain lesion localization) were considered as predictive factors. Regression analyses revealed that the DAS and FRI values are differently influenced by demographic and clinical factors in patients and caregivers. Indeed, the highest educational level corresponds to better DAS and FRI values for patients. In the spouses, the variability of the DAS values was explained by aetiology (the spouses of traumatic ABI patients had worse DAS values), whereas the variability in the FRI values was explained by religious commitment (spending much time on religious activities was associated with better FRI values). Our data suggest that some clinical and demographic variables might be important for protecting against marital dissatisfaction after an ABI.

Cognitive function and its influencing factors in empty-nest elderly and non-empty-nest elderly adults in China

INTRODUCTION

We investigated cognitive function and its influencing factors in empty-nest and non-empty-nest elderly adults in China.

RESULTS

Cognitive function was better in empty-nest elderly living as a couple but worse in those living alone than in non-empty-nest elderly. Older age, rural habitation, poorer instrumental activities of daily living, and depression were risk factors for cognitive decline, while higher education was protective. Women had poorer cognitive function than men among non-empty-nest elderly and empty-nest elderly living as a couple. Among non-empty-nest elderly, those who were divorced/widowed/never married, underweight or economically active exhibited poorer cognitive function. Having two or more chronic diseases and being overweight were associated with better cognitive function among empty-nest elderly living as a couple.

CONCLUSION

These findings suggest that cognitive function is poorest in empty-nest elderly living alone and best in empty-nest elderly living as a couple. The factors influencing cognitive function differed according to empty-nest status, which should be considered in interventions.

METHODS

5549 elderly from the 2015 China Health and Retirement Longitudinal Study were included in this study. Cognitive function was evaluated using the Telephone Interview for Cognitive Status, episodic memory tests and visuospatial ability assessments. Factors influencing cognitive function were determined via multiple linear regression analysis.

Chronic condition discordance and physical activity among midlife and older couples

OBJECTIVE

Chronic conditions in middle and later life are associated with lower physical activity. Yet little is known about chronic condition discordance (i.e., the extent to which conditions have nonoverlapping self-management requirements) within older individuals and couples and its implications for physical activity. We determined how the degrees of chronic condition discordance at the individual level and the couple level (i.e., between spouses) were linked to moderate physical activity across an 8-year period.

METHOD

The U.S. sample included 1,621 couples from five waves of the Health and Retirement Study (2006-2014). Dyadic growth curve models estimated how individual-level and couple-level chronic condition discordance were linked to initial levels of and rates of change in moderate activity. Models controlled for age, minority status, education, and own and partner reports of baseline negative marital quality, time-varying depressive symptoms, and time-varying number of chronic conditions.

RESULTS

A considerable proportion of wives (25.4%) and husbands (18.9%) reported moderate activity less than once a week. When individuals (wives: β = -0.10; husbands: β = -0.09) or their spouses (wives: β = -0.04; husbands: β = -0.05) had greater individual-level chronic condition discordance, lower initial moderate activity was reported. When husbands had greater individual-level discordance, both wives (β = -0.16) and husbands (β = -0.19) had a faster rate of decline in moderate activity over time. Couple-level chronic condition discordance was not significantly linked to moderate activity.

CONCLUSIONS

These findings suggest the importance of promoting physical activity among individuals and couples managing complex chronic conditions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Impact of Spouse's Illness on Depressive Symptoms: The Roles of Spousal Caregiving and Marital Satisfaction

OBJECTIVES

To examine (a) the relationship between own depressive symptoms and spouses' health condition changes among mid- and later-life couples and (b) the roles of marital relationship quality and spousal caregiving in this relationship.

METHOD

Fixed-effect analyses were conducted using data from 3,055 couples aged 45 and older from Waves 1 (2006) to 4 (2012) of the Korean Longitudinal Study on Ageing.

RESULTS

Spousal stroke was linked with higher depression symptoms. Spouses' onset of cancer was related to an increase in depressive symptoms for wives, but not for husbands. Spousal caregiving and marital satisfaction were significant moderators: Wives caring for spouses with cancer reported more depressive symptoms than those not providing care; husbands caring for spouses with lung disease reported more depressive symptoms than those not providing care. The associations between wives' heart disease, husbands' cancer diagnosis, and depressive symptoms were weaker for couples with higher marital satisfaction.

DISCUSSION

The findings suggest variations across health condition types and gender. Relationship quality and caregiving are important contexts moderating the negative impact of spousal chronic illness on depression. Health care providers should be aware that spouses' health statuses are connected and that type of illness may affect the care context.

Health and Union Dissolution among Parenting Couples: Differences by Gender and Marital Status

Poor health may destabilize romantic unions by impeding fulfillment of family responsibilities, increasing stress, and causing financial strain. We hypothesized that the associations of health characteristics with union stability for parenting couples vary by the gender of the partner in poor health and the couple's marital status because of gender and marital status differences in family responsibilities and health-related coping behaviors. Using longitudinal data from the Fragile Families and Child Wellbeing Study (n = 2,997), we examined how three health measures predicted union dissolution for urban married and cohabiting couples with young children. Fathers' depression at baseline predicted dissolution for all parenting couples, as did either partner developing depression between baseline and the following interview. For married parents, fathers' health-related work limitations and mothers' poor self-rated health also predicted dissolution. Associations between health conditions and dissolution differ by gender and marital status, possibly reflecting varying social norms about family responsibilities.

Dyadic effects of depressive symptoms on medical morbidity in middle-aged and older couples

OBJECTIVE

Depressive symptoms in middle and later life are associated with an increased risk of greater medical morbidity (i.e., number of chronic health conditions). Yet little is known about mutual influences that may occur within married couples. This study examined the effects of wives' and husbands' depressive symptoms on their own and their partner's number of chronic health conditions over an 8-year period. It was also determined whether these effects varied by gender.

METHOD

The U.S. sample included 992 heterosexual couples (M = 63.58 years at baseline) drawn from 5 waves of the Health and Retirement Study (2006-2014). Dyadic growth curve models were estimated to evaluate the effects of own and partner baseline depressive symptoms on medical morbidity across time. Models controlled for baseline marital duration and negative marital quality along with age, education, minority status, health-related self-efficacy, body mass index, disability status, alcohol use, smoking, and moderate and vigorous physical activity.

RESULTS

Husbands' higher baseline depressive symptoms were significantly linked to their own higher number of chronic conditions. When wives had higher depressive symptoms at baseline, husbands showed significantly greater increases in their number of chronic conditions over time. Own and partner depressive symptoms were not significantly associated with baseline levels or changes in wives' number of chronic conditions.

CONCLUSIONS

This study demonstrates that depressive symptoms within middle-aged and older couples may have long-term associations with medical morbidity. Findings underscore the value of considering the implications of depressive symptoms for chronic health conditions among individuals and couples. (PsycINFO Database Record

Affective concordance in couples: a cross-sectional analysis of depression and anxiety consultations within a population of 13,507 couples in primary care

BACKGROUND

Depression and anxiety are common and have a significant impact on the individual and wider society. One theory proposed to explain a heightened risk for depression and anxiety is affective concordance in couples (e.g. influence of shared mood states, shared health beliefs). Whilst research has shown concordance for severe psychiatric illnesses and general mood in couples, little attention has been given to concordance for common psychiatric conditions such as depression and anxiety. The aims of this study were to test affective concordance in couples and examine potential influences on concordance.

METHODS

Study design is a 1-year cross-sectional study of anxiety and depression consultations in primary care. Data were obtained from a validated primary care database of recorded consultations. Outcome was the presence of an anxiety or depression Read Code (GP recorded reason for consultation) in the female (within the couple dyad), and exposure was a recorded Read Code of anxiety or depression in the male. Logistic regression was used to test associations with odds ratios (OR) and 95% confidence intervals (95% CI) reported. Statistical adjustment was carried out on potential influences of concordance; age, environment (deprivation), healthcare behaviour (consultation frequency), and comorbidity.

RESULTS

A population of 13,507 couples were identified in which 927 people consulted for anxiety and 538 for depression. Logistic regression showed a 3 times increase in odds of an anxiety consultation in females if their male partner had also consulted OR 2.98 (95% CI 2.15 to 4.13). For depression females were over 4 times the odds of consulting if their male partner had also consulted OR 4.45 (95% CI 2.79 to 7.09). Adjustment within a multivariable model showed some reduction in odds; concordant anxiety was reduced to 2.5 times odds OR 2.48 (95%CI 1.76 to 3.50) and depression reduced to OR 3.39 (2.07 to 5.54).

CONCLUSION

Results show significant associations for affective concordance in couples. Factors influencing concordance are comorbidity and environmental factors, however reasons for deciding to consult (positive or negative) are unknown. This study highlights the patients' social context as a factor in consultations for anxiety and depression and gives support to the consideration of the patient's household as an influence on mental health.

Binge Drinking and Depression: The Influence of Romantic Partners in Young Adulthood

Although research shows that spouses influence each other's health behaviors and psychological well-being, we know little about whether these patterns extend to young people in nonmarital as well as marital relationships. We use the National Longitudinal Study of Adolescent to Adult Health to consider how a romantic partner's binge drinking and depression influence the respondent's binge drinking and depression within 1,111 young adult couples and explore whether these processes are moderated by gender. We find that partners' binge drinking is associated with increased odds of binge drinking for respondents, and partners' depression is associated with increased odds of depression for respondents. Further, depression among men is associated with reduced odds of binge drinking among their female partners. Findings suggest that processes of partner influence begin even in young adulthood with implications for cumulative effects on lifelong health behaviors and mental health.