The relationship between major depression and the salutogenic construct of sense of coherence was investigated. The Sense of Coherence scale and the Beck Depression Inventory were administered to 50 patients diagnosed with major depressive disorder and to 50 control subjects. Significant negative correlations were found between scores on Depression and total scores on the Sense of Coherence scale as well as all three of its subscales (Comprehensibility, Manageability, and Meaningfulness). A significant positive correlation was found between scores on the Sense of Coherence scale and age. Of the three subscales, a low score on Meaningfulness was the best predictor of scores on Depression.

The incidence and nature of headaches in 85 systemic lupus erythematosus (SLE) patients attending an outpatient clinic were studied and compared to those experienced by 61 nurses. The two groups were similar in age, sex and ethnicity. Test-retest assessment of reliability gave both groups 95% confidence limits of 0.09-0.21. Thirty-two (38%) patients developed migrainous headaches and nine (10%) stress headaches with the onset of lupus. In the control group, four (6%) developed migraine and 40 (66%) developed stress headaches on commencing work. We could not document any association of headaches with flares of systemic disease, the ACA syndrome, Raynaud's phenomenon or increased SLEDAI score. We conclude that migrainous headaches are more common in lupus patients than healthy controls, but in an outpatient setting are not statistically associated with flares of systemic disease.

The relationships between the coping strategies used by spouses of clinically depressed patients and spouses' anxiety, depression, and marital maladjustment were investigated. Fifty spouses of clinically depressed patients completed a biographical questionnaire, the Coping Strategy Indicator (J. H. Amirkhan, 1990, 1994), the Beck Depression Inventory (A. T. Beck, 1967; A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961), the State-Trait Anxiety Inventory (C. D. Spielberger, R. E. Lushene, B. A. Vagg, & E. Jacobs, 1983), and the Locke-Wallace Marital Adjustment Test (H. J. Locke & K. M. Wallace, 1959, 1987). Anxiety was highly prevalent in the spouses; more than half were depressed, and half showed marital maladjustment. Significant positive correlations were found between an avoidant coping strategy and anxiety as well as depression, and a significant negative correlation was found between an avoidant coping strategy and marital adjustment. These findings indicate the ineffectiveness of an avoidant coping strategy for spouses of clinically depressed patients.

There were no significant differences in age, level of education, incidence of hypertension or disease activity in the two groups. Pearson's correlation coefficients revealed a significant negative correlation with duration of disease in six out of eight tests in the aPL positive group and one out of eight in the aPL negative group. This suggests that aPL syndrome may be involved in the psychological impairment in SLE patients. A larger cohort needs to be studied to confirm this observation.