Pain and the marital relationship: Psychiatric distress

Abstract

Psychologic assessment and treatment of the family of the chronic pain patient has been thought to be of benefit in the outcome of pain therapy. The present study was designed to determine the presence of psychologic symptoms in the spouses of pain patients and the relationship of distress levels between the marital pair. Forty-four couples were studied. Demographic data was collected and each individual completed the SCL-90, a widely used and validated measure of psychologic symptom severity. There was a significant correlation (P = less than 0.001) on psychiatric distress scores between pain patients and their spouses particularly when pain patient distress scores were high. Distress levels tended to decrease with age and were highest among the unemployed and lowest in the retired. In addition spouses were significantly higher than nonpatient norms on most symptom subscales. These data underline the importance of conjoint assessment of the chronic pain patient and the spouse, and have implications for treatment.

Illness Behavior in Children of Chronic Pain Patients

“…It has been suggested that poor family support and marital disharmony influences the severity and duration of pain complaints of pain patients [2-41. Families of patients with chronic pain often show a marked incidence of stress [5], alcoholism [2,6], and psychological disorder [7], and pain symptomatology [l, 8, 91. Many studies have examined the deleterious effects patients with chronic pain have on their spouses [2, 10-141.…”

Pain affects spouses too: Personal experience with pain and catastrophizing as correlates of spouse distress

“…For example, spouses of ICPs report elevated psychological distress when compared to spouses of diabetic patients and healthy individuals (Shanfield et al, 1979;Rowat and Knafl, 1985;Flor et al, 1987a;Subramanian, 1991;Smith et al, 1999;Bigatti and Cronan, 2002). An understanding of how pain impacts the psychological distress of spouses requires a conceptual framework that accounts for characteristics of both partners.…”

Os modelos de senso-comum das cefaleias crónicas nos casais: Relação com o ajustamento marital

“…Resultados idênticos foram encontrados em estudos que referem um número substancial de cônjuges de pacientes de dor crónica que não mencionam insatisfação marital (Flor et al, 1989;Shanfield & Heiman, 1979). Uma interpretação possível pode estar relacionada com a função homeostática da dor, no sentido do evitamento de conflitos maritais, conforme resultados anteriores (ex.…”

“…Existe evidência de que a dor crónica tem sé-rios efeitos no ajustamento marital dos cônjuges e dos pacientes (Maruta & Osborne, 1978;Shanfield & Heiman, 1979). Várias investigações identificaram desajustamento marital e sexual em doentes com dor crónica (Flor, Turk, & Rudy, 1989;Flor, Kerns & Turk, 1987;Maruta & Osborne, 1978;Mohamed, Weisz & Waring, 1978) mas alguns cônjuges de doentes com dor crónica mencionaram maior insatisfação marital e depressão do que os pacientes (Kerns, Haythornthwaite, Southwick & Giller, 1990).…”