title: The psychosocial impact of severe hypoglycemic episodes on spouses of patients with IDDM.
abstract: OBJECTIVE
  No previous studies have examined the psychosocial impact of severe hypoglycemic episodes in IDDM patients on their spouses. This study compared spouses of IDDM patients with and without a history of recent severe hypoglycemia (SH) using traditional measures of psychosocial status and marital conflict, as well as diabetes-specific measures.
  
  
  METHODS
  A total of 61 nondiabetic spouses (23 wives and 38 husbands) of IDDM patients participated in the study. Spouses completed a battery of traditional psychometric measures (depression, anxiety, marital conflict) and diabetes-specific measures (fear of hypoglycemia, marital conflict over diabetes, sleep disturbance caused by hypoglycemia). Scores of spouses of IDDM patients with and without a recent history of SH were compared with t tests.
  
  
  RESULTS
  Spouses of IDDM patients with and without a recent history of SH showed no differences on traditional psychometric measures of depression, anxiety, and marital conflict. However, spouses of patients with a recent history of SH showed significantly more fear of hypoglycemia, marital conflict about diabetes management, and sleep disturbances caused by hypoglycemia. Exploratory analyses of variance (ANOVAs) found no differences on psychometric measures between wives and husbands, with the exception that husbands of SH patients reported more sleep disturbance. Nondiabetic spouses, on average, showed greater fear of hypoglycemia than their diabetic partners.
  
  
  CONCLUSIONS
  Although SH in IDDM patients can have a significant impact on the psychosocial status of their spouses, in this study the negative impact was restricted to areas of life that are directly related to diabetes and its management. Thus, SH per se is not necessarily associated with significant increases in spousal anxiety, depression, or marital conflict, but may be associated with types of diabetes-specific psychosocial distress that are not easily identified by traditional psychometric measures.
authors.affiliation: Department of Psychiatric Medicine, University of Virginia Health Sciences Center, Charlottesville 22908, USA. lag3g@virginia.edu
authors.forename: L
authors.initials: L
authors.lastname: Gonder-Frederick
authors.forename: D
authors.initials: D
authors.lastname: Cox
authors.forename: B
authors.initials: B
authors.lastname: Kovatchev
authors.forename: D
authors.initials: D
authors.lastname: Julian
authors.forename: W
authors.initials: W
authors.lastname: Clarke
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety; D003220:Conflict, Psychological; D003863:Depression; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D007328:Insulin / Q000009:adverse effects; D008297:Male; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012737:Sex Factors; D012893:Sleep Wake Disorders; D012917:Social Adjustment; D018454:Spouses / Q000523:psychology*
chemical_list: D007328:Insulin