Abstract:
OBJECTIVE:Married persons have, on average, better mental health than nonmarried persons. Among married persons, marital satisfaction is associated with better mental health. Studies on mental health in married and nonmarried persons that consider marital satisfaction have categorized patients as satisfied versus unsatisfied, which reduces statistical power and does not generate clinically useful information on mental health across the satisfaction spectrum. Our objective was to demonstrate a novel regression approach to evaluate mental health in women with systemic sclerosis (SSc), comparing married and unmarried women, accounting for continuously measured marital satisfaction. METHODS:Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and marital satisfaction with the Dyadic Adjustment Scale-7. A single multiple linear regression model was used to predict CES-D scores from marital status and, among married women, continuously measured marital satisfaction, controlling for demographic and clinical characteristics. RESULTS:Of 725 women, 494 (68%) were married or living as married. On average, married women had mean CES-D scores that were 2.0 points (0.19 SDs) lower than unmarried women (P = 0.013). Among married women, a 1.0 SD increase in marital satisfaction was associated with a 2.2 point (0.21 SDs) decrease in CES-D scores (P < 0.001). Married women whose marital satisfaction scores were below the 19th percentile had greater predicted depressive symptoms than unmarried women. Married women's predicted CES-D scores ranged from 6.7 points lower to 6.9 points higher than those of unmarried women, depending on marital satisfaction. CONCLUSION:Comparisons of mental health in married and unmarried patients with rheumatic diseases should include continuously measured marital satisfaction.
journal_name
Arthritis Care Res (Hoboken)journal_title
Arthritis care & researchauthors
Levis B,Rice DB,Kwakkenbos L,Steele RJ,Hagedoorn M,Hudson M,Baron M,Thombs BD,Canadian Scleroderma Research Group.doi
10.1002/acr.22802subject
Has Abstractpub_date
2016-08-01 00:00:00pages
1143-9issue
8eissn
2151-464Xissn
2151-4658journal_volume
68pub_type
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