title: Myotonic dystrophy: the burden for patients and their partners.
abstract: OBJECTIVE
  Dystrophia myotonica is characterized by progressive muscular weakness, myotonia, mental slowness and lack of initiative, which causes problems in daily life both for patients and for their spouses. Some couples seem to deal with these problems satisfactorily, while for others they are quite burdensome. The aim of this study was to describe the relationship of severity of dystrophia myotonica and psychological wellbeing in patients and partners.
  
  
  METHODS
  Sixty-nine couples, in whom one partner had dystrophia myotonica, completed questionnaires on severity of dystrophia myotonica, marital satisfaction, anxiety and depression (Hospital Anxiety and Depression Scale), hopelessness (Beck Hopelessness Scale) and general psychological health (General Health Questionnaire-12).
  
  
  RESULTS
  For patients, a worse view of the future, worse general wellbeing, more anxiety and more depression was associated with a greater need for help. For partners, worse general wellbeing and more anxiety was associated with a lack of initiative of the patient and less marital satisfaction. It is noteworthy that 40% of patients and particularly female partners had Beck Hopelessness Scale scores suggestive of clinically relevant depression.
  
  
  CONCLUSIONS
  Dystrophia myotonica places a heavy burden on patients, and especially on female partners. The need for help and dependency has more influence on the wellbeing of patients than the symptoms of dystrophia myotonica themselves. Marital satisfaction is a strong predictor of better wellbeing, both for patients and, even more so, for partners.
authors.affiliation: Department of Medical Psychology and Psychotherapy, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands. r.timman@erasmusmc.nl
authors.forename: Reinier
authors.initials: R
authors.lastname: Timman
authors.forename: Aad
authors.initials: A
authors.lastname: Tibben
authors.forename: Axel R
authors.initials: AR
authors.lastname: Wintzen
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003863:Depression / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008393:Marriage / Q000523:psychology; D008875:Middle Aged; D009223:Myotonic Dystrophy / Q000451:nursing / Q000523:psychology* / Q000534:rehabilitation; D011788:Quality of Life; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000175:diagnosis; D011795:Surveys and Questionnaires