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Abstract
Background
Depression is known to affect family function and communication. However, the distress experienced by those who have spouse with depression has not been properly assessed to date. This study attempted to examine the effect of depression on family function and communication as reported by the spouses of the depressed patients.
Methods
The participants of this study were 445 couples who visited 28 family doctors from April 2009 to June 2011. The Family Adaptability and Cohesion Evaluation Scale III (FACES-III) was used to evaluate the family function, and the family communication scale in FACES-IV was used to evaluate communication among family members. A score of more than 21 points on the CES-D scale was used to indicate depression. The relationships between family type, family communication, and the depression of one's spouse were analyzed using the chi-square test and logistic regression.
Results
The odds ratios, indicating how the family is heading towards an extreme level, were statistically significant in all male and female respondents (male: odds ratio [OR] 3.08, 95% confidence interval [CI] 1.73–5.48; female: OR 2.09, 95% CI 1.02–4.27). On the other hand, only female respondents with depressed spouses reported their family communication not to be good (male: OR 1.65, 95% CI 0.88–3.07; female: OR 2.48, 95% CI, 1.25–4.93).
References
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Table 1.
Demographic and clinical characteristics of the study participants
| Male | Female | |||||
|---|---|---|---|---|---|---|
| Subjects with | Subjects without | Subjects with | Subjects without | |||
| spouse's depressiona | spouse's depression | P valueb | spouse's depression | spouse's depression | P value | |
| (n＝71) | (n＝374) | (n＝45) | (n＝400) | |||
| Age, years | 0.01 | 0.57 | ||||
| Mean±SD | 62.0±8.5 | 62.0±10.0 | 59.67±9.7 | 58.51±9.4 | ||
| ＜50 | 3 (4.2) | 57 (15.2) | 6 (13.3) | 79 (19.8) | ||
| 50–59 | 25 (35.2) | 74 (19.8) | 12 (26.7) | 123 (30.8) | ||
| 60–69 | 30 (42.3) | 150 (40.1) | 20 (44.4) | 149 (37.2) | ||
| ＞70 | 13 (18.3) | 93 (87.7) | 7 (15.6) | 49 (87.5) | ||
| Education (duration, years) | 0.05 | 0.01 | ||||
| ＜12 | 33 (46.5) | 220 (58.8) | 11 (24.4) | 153 (38.2) | ||
| 12 | 22 (31.0) | 107 (28.6) | 14 (31.1) | 149 (37.2) | ||
| ＞12 | 16 (22.5) | 47 (12.6) | 20 (44.4) | 98 (24.5) | ||
| Monthly income, 10,000 won/month | 0.01 | 0.001 | ||||
| ≥ 600 | 18 (25.4) | 117 (31.3) | 4 (8.9) | 115 (28.7) | ||
| 400–599 | 14 (19.7) | 83 (22.2) | 6 (13.3) | 95 (23.8) | ||
| 200–399 | 18 (25.4) | 123 (32.9) | 20 (44.4) | 125 (31.2) | ||
| ＜200 | 21 (29.6) | 51 (13.6) | 15 (33.3) | 65 (16.2) | ||
| Smoking | 1.00 | 1.00 | ||||
| Current smoker | 19 (26.8) | 100 (26.7) | 6 (13.3) | 53 (13.2) | ||
| Ex/never smoker | 52 (73.2) | 274 (73.3) | 39 (86.7) | 347 (86.8) | ||
| Physical activityc | 0.05 | 0.45 | ||||
| High | 26 (36.6) | 139 (37.2) | 9 (20.0) | 115 (28.7) | ||
| Moderate | 16 (22.5) | 130 (34.8) | 16 (35.6) | 132 (33.0) | ||
| Low | 29 (40.8) | 105 (28.1) | 20 (44.4) | 153 (38.2) | ||
| Diabetes mellitus | 0.36 | 0.70 | ||||
| Yes | 17 (25.0) | 111 (30.5) | 6 (13.6) | 45 (11.6) | ||
| No | 51 (75.0) | 253 (69.5) | 38 (86.4) | 342 (88.4) | ||
| Hypertension | 0.49 | 0.43 | ||||
| Yes | 39 (57.4) | 172 (47.3) | 17 (38.6) | 127 (32.7) | ||
| No | 29 (42.6) | 192 (52.7) | 27 (61.4) | 261 (67.3) | ||
Table 2.
Comparison of adaptability and cohesion between subjects with spouse's depression and subjects without spouse's depression
| Subjects with spouse's depression | Subjects without spouse's depression | P valuea | ||
|---|---|---|---|---|
| Male | ||||
| Adaptability | Rigid | 30 (42.3) | 78 (20.9) | 0.002 |
| Structured | 17 (23.9) | 122 (32.6) | ||
| Flexible | 12 (16.9) | 99 (26.5) | ||
| Chaotic | 12 (16.9) | 75 (20.1) | ||
| Cohesion | Disengaged | 48 (67.6) | 173 (46.3) | 0.01 |
| Separated | 12 (16.9) | 105 (28.1) | ||
| Connected | 9 (12.7) | 75 (20.1) | ||
| Enmeshed | 2 (2.8) | 21 (5.6) | ||
| Female | ||||
| Adaptability | Rigid | 13 (28.9) | 69 (17.2) | 0.13 |
| Structured | 12 (29.4) | 119 (29.8) | ||
| Flexible | 7 (15.6) | 112 (28.0) | ||
| Chaotic | 13 (28.9) | 100 (25.0) | ||
| Cohesion | Disengaged | 26 (57.8) | 167 (41.8) | 0.09 |
| Separated | 13 (28.9) | 115 (28.7) | ||
| Connected | 5 (11.1) | 82 (20.5) | ||
| Enmeshed | 1 (2.2) | 36 (9.0) | ||
Table 3.
Comparison of family functioning and communication between subjects with spouse's depression and subjects withou spouse's depression
Table 4.
Multivariate logistic regression to predict odds ratio of extreme family type and poor family communication according to presence of spouse's depressiona
| Appropriate | Extreme | Adjusted OR | Good | Poor | Adjusted OR | ||
|---|---|---|---|---|---|---|---|
| family type | family type | (95%CI) | communication | communication | (95%CI) | ||
| Male | |||||||
| Spouse's depression | No | 300 (80.2) | 74 (19.8) | 1 (reference) | 300 (80.2) | 74 (19.8) | 1 (reference) |
| Yes | 41 (57.7) | 30 (42.3) | 3.08 (1.73–5.48)b | 48 (67.6) | 23 (32.4) | 1.65 (0.88–3.07)d | |
| Female | |||||||
| Spouse's depression | No | 317 (79.2) | 83 (20.8) | 1 (reference) | 324 (81.0) | 76 (19.1) | 1 (reference) |
| Yes | 30 (66.7) | 15 (33.3) | 2.09 (1.02–4.27)c | 27 (60.0) | 18 (40.0) | 2.48 (1.25–4.93)e | |
Abbreviations: OR, odds ratio; CI, confidence interval. Extreme Families are those in the corners representing the extremes of Cohesion and Adaptability in Circumplex Model (sixteen types of marital and family systems). Family communication was investigated using Family Communication Scales (FCS) included in FACES-IV. Family communication is classified into 2 groups by total score. The good communication group was in the range of 36–50 points, and poor group was in the range of 10–35 points.
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