The Impact of a Spouse's Depression on Family Functioning and Communication

Seung-Hyun Yoo; Hyuk-Ju Kwon; Sun-Hee Kim; Jung-Ah Lee; Sung Sunwoo; Young-Sik Kim; Byung-Su Kim; Han-Jin Oh; Chul-Min Kim; Hee-Jeong Choi; Hee-Jin Hwang; Sun-Wha Ok

doi:10.15384/kjhp.2016.16.1.11

Korean J Health Promot > Volume 16(1); 2016 > Article

Yoo, Kwon, Kim, Lee, Sunwoo, Kim, Kim, Oh, Kim, Choi, Hwang, and Ok: The Impact of a Spouse's Depression on Family Functioning and Communication

Original Article

Korean Journal of Health Promotion 2016;16(1):11-19.

Published online: January 20, 2016

DOI: https://doi.org/10.15384/kjhp.2016.16.1.11

The Impact of a Spouse's Depression on Family Functioning and Communication

Seung-Hyun Yoo¹, Hyuk-Ju Kwon¹, Sun-Hee Kim¹, Jung-Ah Lee¹, Sung Sunwoo¹, Young-Sik Kim^1,, Byung-Su Kim², Han-Jin Oh³, Chul-Min Kim⁴, Hee-Jeong Choi⁵, Hee-Jin Hwang⁶, Sun-Wha Ok⁷

¹Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

²Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

³Department of Family Medicine, Vievis Namuh Hospital, Seoul, Korea

⁴Department of Family Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea

⁵Department of Family Medicine, Eulji University School of Medicine, Daejeon, Korea

⁶Department of Family Medicine, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Seoul, Korea

⁷Department of Child Development and Family Studies, Institute of Human Ecology, Seoul National University, Seoul, Korea

Corresponding author: Young-Sik Kim, MD, MPH, PhD Departments of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
Tel: +82-2-3010-3811, Fax: +82-2-3010-3815 E-mail: youngkim@amc.seoul.kr

Received September 16, 2015 Accepted November 06, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background

Depression is known to affect family function and communication. However, the distress experienced by those who have spouse with depression has not been properly assessed to date. This study attempted to examine the effect of depression on family function and communication as reported by the spouses of the depressed patients.

Methods

The participants of this study were 445 couples who visited 28 family doctors from April 2009 to June 2011. The Family Adaptability and Cohesion Evaluation Scale III (FACES-III) was used to evaluate the family function, and the family communication scale in FACES-IV was used to evaluate communication among family members. A score of more than 21 points on the CES-D scale was used to indicate depression. The relationships between family type, family communication, and the depression of one's spouse were analyzed using the chi-square test and logistic regression.

Results

The odds ratios, indicating how the family is heading towards an extreme level, were statistically significant in all male and female respondents (male: odds ratio [OR] 3.08, 95% confidence interval [CI] 1.73–5.48; female: OR 2.09, 95% CI 1.02–4.27). On the other hand, only female respondents with depressed spouses reported their family communication not to be good (male: OR 1.65, 95% CI 0.88–3.07; female: OR 2.48, 95% CI, 1.25–4.93).

Conclusions

This study revealed people perceive their family function and communication not good when they have spouses with depression. There was no gender difference in the evaluation of their family function, but the perception on their family communication were different by gender.

Keywords: Depression, Spouses, Family functioning, Commuincation

Table 1.

Demographic and clinical characteristics of the study participants

	Male			Female
	Subjects with	Subjects without		Subjects with	Subjects without
	spouse's depression^a	spouse's depression	P value^b	spouse's depression	spouse's depression	P value
	(n＝71)	(n＝374)		(n＝45)	(n＝400)
Age, years			0.01			0.57
Mean±SD	62.0±8.5	62.0±10.0		59.67±9.7	58.51±9.4
＜50	3 (4.2)	57 (15.2)		6 (13.3)	79 (19.8)
50–59	25 (35.2)	74 (19.8)		12 (26.7)	123 (30.8)
60–69	30 (42.3)	150 (40.1)		20 (44.4)	149 (37.2)
＞70	13 (18.3)	93 (87.7)		7 (15.6)	49 (87.5)
Education (duration, years)			0.05			0.01
＜12	33 (46.5)	220 (58.8)		11 (24.4)	153 (38.2)
12	22 (31.0)	107 (28.6)		14 (31.1)	149 (37.2)
＞12	16 (22.5)	47 (12.6)		20 (44.4)	98 (24.5)
Monthly income, 10,000 won/month			0.01			0.001
≥ 600	18 (25.4)	117 (31.3)		4 (8.9)	115 (28.7)
400–599	14 (19.7)	83 (22.2)		6 (13.3)	95 (23.8)
200–399	18 (25.4)	123 (32.9)		20 (44.4)	125 (31.2)
＜200	21 (29.6)	51 (13.6)		15 (33.3)	65 (16.2)
Smoking			1.00			1.00
Current smoker	19 (26.8)	100 (26.7)		6 (13.3)	53 (13.2)
Ex/never smoker	52 (73.2)	274 (73.3)		39 (86.7)	347 (86.8)
Physical activity^c			0.05			0.45
High	26 (36.6)	139 (37.2)		9 (20.0)	115 (28.7)
Moderate	16 (22.5)	130 (34.8)		16 (35.6)	132 (33.0)
Low	29 (40.8)	105 (28.1)		20 (44.4)	153 (38.2)
Diabetes mellitus			0.36			0.70
Yes	17 (25.0)	111 (30.5)		6 (13.6)	45 (11.6)
No	51 (75.0)	253 (69.5)		38 (86.4)	342 (88.4)
Hypertension			0.49			0.43
Yes	39 (57.4)	172 (47.3)		17 (38.6)	127 (32.7)
No	29 (42.6)	192 (52.7)		27 (61.4)	261 (67.3)

Values are presented as number (%) or mean±SD.

^aDepression: Center for Epidemiologic Studies Depression Scale CES-D) score ≥ 21.

^bP value was calculated using the chi-square test.

^cCategorized by International Physical Activity Questionnaire (IPAQ) short-form.

Table 2.

Comparison of adaptability and cohesion between subjects with spouse's depression and subjects without spouse's depression

		Subjects with spouse's depression	Subjects without spouse's depression	P value^a
Male
Adaptability	Rigid	30 (42.3)	78 (20.9)	0.002
	Structured	17 (23.9)	122 (32.6)
	Flexible	12 (16.9)	99 (26.5)
	Chaotic	12 (16.9)	75 (20.1)
Cohesion	Disengaged	48 (67.6)	173 (46.3)	0.01
	Separated	12 (16.9)	105 (28.1)
	Connected	9 (12.7)	75 (20.1)
	Enmeshed	2 (2.8)	21 (5.6)
Female
Adaptability	Rigid	13 (28.9)	69 (17.2)	0.13
	Structured	12 (29.4)	119 (29.8)
	Flexible	7 (15.6)	112 (28.0)
	Chaotic	13 (28.9)	100 (25.0)
Cohesion	Disengaged	26 (57.8)	167 (41.8)	0.09
	Separated	13 (28.9)	115 (28.7)
	Connected	5 (11.1)	82 (20.5)
	Enmeshed	1 (2.2)	36 (9.0)

^aP value was calculated using the chi-square test.

Table 3.

Comparison of family functioning and communication between subjects with spouse's depression and subjects withou spouse's depression

		Subjects with spouse's depression	Subjects without spouse's depression	P value^a
Male
Family type	Appropriate	41 (57.7)	300 (80.2)	＜0.001
	Extreme	30 (42.3)	74 (19.8)
Communication	Good	48 (67.6)	300 (80.2)	0.02
	Poor	23 (32.4)	74 (19.8)
Female
Family type	Appropriate	30 (66.7)	317 (79.2)	0.05
	Extreme	15 (33.3)	83 (20.8)
Communication	Good	27 (60.0)	324 (81.0)	0.001
	Poor	18 (40.0)	76 (19.0)

^aP value was calculated using the chi-square test.

Table 4.

Multivariate logistic regression to predict odds ratio of extreme family type and poor family communication according to presence of spouse's depression^a

		Appropriate	Extreme	Adjusted OR	Good	Poor	Adjusted OR
		family type	family type	(95%CI)	communication	communication	(95%CI)
Male
Spouse's depression	No	300 (80.2)	74 (19.8)	1 (reference)	300 (80.2)	74 (19.8)	1 (reference)
	Yes	41 (57.7)	30 (42.3)	3.08 (1.73–5.48)^b	48 (67.6)	23 (32.4)	1.65 (0.88–3.07)^d
Female
Spouse's depression	No	317 (79.2)	83 (20.8)	1 (reference)	324 (81.0)	76 (19.1)	1 (reference)
	Yes	30 (66.7)	15 (33.3)	2.09 (1.02–4.27)^c	27 (60.0)	18 (40.0)	2.48 (1.25–4.93)^e

Abbreviations: OR, odds ratio; CI, confidence interval. Extreme Families are those in the corners representing the extremes of Cohesion and Adaptability in Circumplex Model (sixteen types of marital and family systems). Family communication was investigated using Family Communication Scales (FCS) included in FACES-IV. Family communication is classified into 2 groups by total score. The good communication group was in the range of 36–50 points, and poor group was in the range of 10–35 points.

^aValues are presented as number (%) or adjusted OR

^bP value＜0.001. Adjusted for age, education, income, physical activity.

^cP value＝0.04. Adjusted for age, education, income.

^dP value＝0.17. Adjusted for age, education, income, physical activity.

^eP value＝0.009. Adjusted for age, education, income.

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