Marital Interaction in Hospitalized Depressed Patients

Nine married depressed female inpatients and their spouses participated in six weekly sessions to assess marital interaction as a function of treatment response. All patients were involved in a 35-day double blind drug treatment study using the antidepressant drug amitriptyline (Elavil). Several quantitative measures of marital interaction including influence, speech, and motor activity were employed. Self-ratings of depression and anxiety were obtained weekly on all patients and spouses. Depressed subjects were divided into two treatment outcome groups on the basis of their final Hamilton Depression Scale scores. Regardless of treatment outcome, there was a significant increase in the patientsʼ influence or power in their marriage over time. At the end of the study, a more equal balance of power was observed. However, it was found that the patientsʼ spouses may be an important factor in predicting ultimate treatment outcome, since the nonrespondersʼ spouses initially rated themselves as significantly more depressed and anxious than the respondersʼ spouses. These differences were even more pronounced at the end of the treatment study, when the nonrespondersʼ spouses appeared equally depressed and more anxious than the responder patients. In addition, responder patients revealed changes over time in paralinguistic behavior and motor activity, which appeared to represent an improvement in their ability to engage in social interaction. A discrepancy between final clinical ratings and self-ratings for responder patients was attributed to a lag phenomenon. A 2-month postdischarge follow-up of six couples suggested at least some stability of these measures over time.