• Richard Schulz, Scott R Beach, Randy S Hebert, Lynn M Martire, Joan K Monin, Connie A Tompkins, and Steven M Albert.
• Department of Psychiatry and University Center for Social and Urban Research, University of Pittsburgh, 121 University Place, Pittsburgh, PA 15260, USA. schulz@pitt.edu
• Am J Geriatr Psychiatry. 2009 Mar 1; 17 (3): 246-54.

ObjectivesTo assess the effects of suffering in a spouse on prevalent and incident psychiatric (depression) and physical morbidity (cardiovascular disease [CVD]) in their partner, controlling for known risk factors for depression and CVD.DesignDescriptive longitudinal study.ParticipantsA total of 1,330 older married couples enrolled in the Cardiovascular Health Study, a large epidemiologic study of the elderly.MeasurementsPredictor variables were physical, psychological, and existential/spiritual indicators of suffering. Primary outcomes were prevalent and incident depression and CVD.ResultsControlling for known risk factors for depression, the authors found a dose-response relationship between suffering in a spouse and concurrent depression in their partner as well as a relationship between suffering and the partner's future risk for depression. With respect to CVD, and controlling for subclinical CVD at baseline, husbands whose wives reported high levels of suffering also had higher rates of prevalent CVD, but there were no significant associations between wives suffering and husbands incident CVD. There were no associations between husbands' suffering and wives' prevalent or incident CVD.ConclusionExposure to spousal suffering is an independent and unique source of distress in married couples that contributes to psychiatric and physical morbidity. More attention should be paid to the interpersonal effects of suffering in married couples and to its role in contributing to morbidity.

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