The Intertwined Relationship Between Depression and Marital Distress: Elements of Marital Therapy Conducive to Effective Treatment Outcome

Abstract

Within the framework of the interpersonal view of depression, this article examines the linkage between depression and four aspects of marital relationship: stress, support, role expectations, and interactional dynamics. Acknowledging the intertwined relationship between depression and marital adjustment, existing models of martial therapy for married depressed patients are examined for the extent to which they address these four aspects. The empirical evidence for the efficacy of these models is also reviewed, suggesting elements of marital therapy that are conducive to effective treatment outcome.

Individual distress and dyadic adjustment over a three‐year follow‐up period in couple therapy: a bi‐directional relationship?

“…Clinically, this indicates that those who became more satisfied with their dyadic relationship at discharge were the ones to experience improvement in depressive symptoms in the oneand three-year follow-up periods. To some degree we find these results in agreement with Kung's (2000) review of both retrospective and longitudinal studies with clinical and community samples, showing that the change in marital adjustment during treatment, as well as at post-treatment level, significantly predicted levels of depressive symptoms and social functioning at follow-up. Furthermore, these findings confirm to some extent the bi-directional relationship Couple therapy, depression and relationship distress 133 between BDI and DAS as suggested in other studies (Karney, 2001;Whisman and Uebelacker, 2003) but goes a step further in indicating different paths of influence between depressive symptoms and dyadic adjustment: (1) Reducing the depressive symptoms should be a major goal both during and after therapy as this predicts improvement in dyadic adjustment; (2) When an optimal level of DAS is reached during treatment, this seems to stimulate continued improvement in BDI during the follow-up period.…”

“…In Whisman's (2001) meta-analysis, the direction of the relationship between depressive symptoms and marital dissatisfaction was inconclusive, although it appeared that marital dissatisfaction more often preceded depression than vice versa. In Kung's (2000) review of both retrospective and longitudinal studies with clinical and community samples, the presence of marital discord occurred prior to the onset of depression. It was also found that the change in marital adjustment during treatment, as well as the post-treatment level, significantly predicted levels of depressive symptoms and social functioning at follow-up.…”

A Community Mental Health Approach in Identifying People at Risk of Poor Mental Health: A Case Study in Hong Kong

“…Consistent with the results of previous studies (e.g., Wong et al, 2009;Ma et al, 2007), the results of our analysis indicate that the high-risk groups are people with fewer resources in society, who have faced with family problems and conflicts, financial pressure and have experienced job loss, separation and divorce, suggesting the plausible association of increased rate of depression with poverty (e.g., Bruce et al, 1991;Kessler et al, 2003), unemployment (Paul & Moser, 2009;Lau, Ma, & Wong, 2006), marital distress, separation and divorce (Kung, 2000). Housewives are found to be the high-risk group, which would probably be accounted for by the low social status of a housewife in society; the repetitive nature of their daily routine may have restrained their growth and development and may have made their life less meaningful.…”

Marital distress and disease progression: A systematic review

“…These results suggest that the physiological concomitants of stress and emotional upset associated with marital distress are manifest in elevated blood pressure that is most pronounced in the home environment [22]. It suggested elements of marital therapy that are conducive to effective treatment outcome [21]. Couples therapy is an important element of effective treatment of depression, alcohol abuse, anxiety disorders, and the functional psychoses [23].…”

“…OPEN ACCESS tempted to take into account the possible effect of marital distress. Kung (2000) suggested elements of marital therapy that are conducive to effective treatment outcome [21]. It is recommended that treatment be designed to help couples be supportive of each another, to adapt, and to cope with the depressive symptoms within the framework of their ongoing marital relations [4].…”