title: Quality of marital relationship and depression: results of a 10-year prospective follow-up study.
abstract: BACKGROUND
  Although the long-term course of depression has been intensively examined, there are only few studies on the long-term development of depressed patients' spousal relationships. The aim of the study was to assess the quality and stability of depressed patients' spousal relationships in the long-term course of depression and to identify predictors of relationship outcome.
  
  
  METHODS
  In the study, 50 inpatients with Major Depression were followed-up one, two and ten years after discharge from hospital and compared to a healthy control group matched by age and sex. Marital satisfaction was measured by the Terman item. Expressed Emotion (EE) was assessed with the Five-Minute Speech Sample (FMSS) and the Perceived Criticism Index (PC).
  
  
  RESULTS
  In the follow-up period of ten years, 26 patients (56.5%) had a recurrence. Ten years after discharge from hospital 8 couples were separated, 11 were unhappy and 26 couples were happy with their spousal relationship. The quality of marital relationship decreased over the follow-up period. In comparison to a healthy control group, patients showed a significantly worse quality of marital relationship at follow-up. Besides age and course of depression, the spousal EE status was a prognostic factor for the quality of the relationship after 10 years.
  
  
  CONCLUSIONS
  The results confirm the decrease of marital satisfaction over time in the long-term course of depression. Identified interpersonal predictors of the quality of spousal relationship in major depression could be used as indication criteria for couple therapy.
authors.affiliation: Department of Psychiatry, University of Heidelberg, Germany. klaus_kronmueller@med.uni-heidelberg.de
authors.forename: Klaus-Thomas
authors.initials: KT
authors.lastname: Kronmüller
authors.forename: Matthias
authors.initials: M
authors.lastname: Backenstrass
authors.forename: Daniela
authors.initials: D
authors.lastname: Victor
authors.forename: Ilinca
authors.initials: I
authors.lastname: Postelnicu
authors.forename: Caroline
authors.initials: C
authors.lastname: Schenkenbach
authors.forename: Katharina
authors.initials: K
authors.lastname: Joest
authors.forename: Peter
authors.initials: P
authors.lastname: Fiedler
authors.forename: Christoph
authors.initials: C
authors.lastname: Mundt
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000523:psychology*; D019260:Expressed Emotion; D005500:Follow-Up Studies; D006801:Humans; D008393:Marriage / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D010549:Personal Satisfaction; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D018454:Spouses / Q000523:psychology* / Q000706:statistics & numerical data; D013997:Time Factors