Spousal Suffering and Partner's Depression and Cardiovascular Disease: The Cardiovascular Health Study
Spousal Suffering and Partner's Depression and Cardiovascular Disease: The Cardiovascular Health Study
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DOI：
10.1097/jgp.0b013e318198775b
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发表时间：
2009-03-01
影响因子：
7.2
通讯作者：
Albert, Steven M.
中科院分区：
文献类型：
--
作者：
Schulz, Richard;Beach, Scott R.;Albert, Steven M.
目的：评估配偶的痛苦对其伴侣的流行和偶发精神病（抑郁症）和身体发病率（心血管疾病[CVD]）的影响，控制抑郁症和CVD的已知风险因素。设计：描述性纵向研究。参与者：共有1,330对老年夫妇参加了心血管健康研究，这是一项针对老年人的大型流行病学研究。测量：预测变量是痛苦的身体、心理和存在/精神指标。主要结果是抑郁症和心血管疾病的患病率和发病率。结果如下：控制已知的抑郁症风险因素，作者发现配偶的痛苦与伴侣的并发抑郁症之间存在剂量反应关系，以及痛苦与伴侣未来抑郁症风险之间的关系。关于心血管疾病，并控制亚临床心血管疾病在基线，丈夫的妻子报告高水平的痛苦也有较高的心血管疾病的患病率，但有没有妻子的痛苦和丈夫的心血管疾病事件之间的显着关联。丈夫的痛苦和妻子的普遍或事件CVD之间没有关联。结论：暴露于配偶的痛苦是一个独立的和独特的来源，在已婚夫妇的痛苦，有助于精神和身体疾病。应更多地注意已婚夫妇遭受痛苦的人际影响及其在促成发病率方面的作用。(Am J Geriatr Psychiatry 2009; 17：246-254）
Objectives: To 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. Design: Descriptive longitudinal study. Participants: A total of 1,330 older married couples enrolled in the Cardiovascular Health Study, a large epidemiologic study of the elderly. Measurements: Predictor variables were physical, psychological, and existential/spiritual indicators of suffering. Primary outcomes were prevalent and incident depression and CVD. Results: Controlling 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. Conclusion: Exposure 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. (Am J Geriatr Psychiatry 2009; 17:246-254)