STRESS, SOCIAL SUPPORT, AND SYMPTOMS OF DEPRESSION IN SPOUSES OF THE MEDICALLY ILL

This study investigated the level and frequency of depressive symptoms in spouses of dialysis patients, as a function of a) severity of patient disease, b) level of stress experienced by the spouse, and c) perception of support from the ill partner. The subjects were forty patients who had begun dialysis in the last year and their spouses. Measures of depression, impact on family, perceived social support, and disease severity were applied. Significant depressive symptoms were reported by 20 percent of spouses. Symptom severity was not correlated with age, sex, or occupation of the spouses, nor with level of depression or functional impairment of the dialysis patients. The amount of social support received from the ill partner accounted for 37 percent of the variance in spouse depression, while social and financial stressors reported by the spouse explained 1.3 percent of the variance in spouse symptoms. These findings suggest that depressive symptoms in spouses of dialysis patients are associated with the social and economic consequences of the illness for the family but even more so with the amount of perceived support from the patient. The determinants of this perceived support need further exploration. (Int'l. J. Psychiatry in Medicine 20~37-48. 1990) Key Words: stress, social support, depression, spouses, chronic illness, renal failure. While the adjustment of patients to chronic medical illness is being studied extensively at present, relatively little systematic research has explored the psychosocial reactions of their spouses. There is descriptive evidence suggesting that such spouses must cope with continuing, and indeed, chronic stressors, particularly in the areas of diminished social functioning, role changes, an