Hundred forty eight more days with depression: the association between marital conflict and depression-free days.
BACKGROUND
Although collaborative care programs are effective in improving late-life depression, only about half of treated patients achieve clinically meaningful improvement. Thus, we need to examine what characteristics may predict poor late-life depression course. Despite the robust evidence for the negative association between the quality of couple relationships and depression outcomes, few studies have examined these associations in the context of long-term late-life depression course.


OBJECTIVE
The objective of this study is to examine the relations between the severity of couple conflict, receiving collaborative depression care program, and 24-months depression outcomes.


METHODS
Study sample comprised 840 depressed older adults subsample from the improving mood, promoting access to collaborative treatment for late-life depression trial (IMPACT). Depression and couple conflict were assessed at baseline, 12-month, and 24-month follow-up. Descriptive statistics and multivariate regression analyses were performed to examine mean 24-month depression-free days (DFD) and the marginal effects of receiving IMAPCT program over usual care among participants with varying degrees of 24-month couple conflict.


RESULTS
Compared with those who never endorsed frequent couple conflict over the three observation points, those who did twice had 63 fewer DFD (p = 0.01), and those who did three times experienced 148 fewer DFD (p < 0.001). Although the marginal effects of receiving IMPACT program over usual care was greater in overall sample, it was not statistically significant among those who endorsed frequent conflict at two or three times.


CONCLUSIONS
Frequent couple conflict is associated with worse long-term late-life depression outcomes among the patients in primary care clinics.
University of Pittsburgh School of Nursing, Department of Health and Community Systems, Pittsburgh, PA, USA.
Mijung
M
Park
Jürgen
J
Unützer
D017668:Age of Onset; D000368:Aged; D015331:Cohort Studies; D003866:Depressive Disorder / Q000209:etiology*; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008393:Marriage; D008875:Middle Aged; D015999:Multivariate Analysis
IMPACT model; late-life depression; marital conflict