[Mental Distress and Resilience in Severe Somatic Diseases: An Analysis of Dyadic Relations].

AIMS

In this article, we present 3 studies examining patients with current or previous severe physical illness and their partners with respect to dyadic concordance, gender and role differences in mental distress and resilience.

METHODS

Study 1 included 55 patients and their partners on average 4.5 years after severe sepsis. Study 2 involved 49 patients with lung cancer, predominantly in advanced stage with metastases, and their partners. In study 3, 69 cancer patients with various tumor entities and tumor stages undergoing additional outpatient homeopathic treatment as well as their partners were examined. All studies used the Hospital Anxiety and Depression Scale (HADS) to measure mental distress and the short version of the Resilience Scale RS-13 to assess resilience as a personality trait. Results were meta-analytically pooled across the 3 studies.

RESULTS

We found dyadic concordances between patient and partner in anxiety (r=0.29 [0.06; 0.48], I=55%) and depression (r=0.44 [0.31; 0.55], I=0%), but not in resilience. Gender differences emerged consistently across all three studies, both female patients and partners showed more severe anxiety symptoms than males (d=0.58 [0.26; 0.91], I=0% for patients; d=0.53 [- 0.06; 1.12], I=69% for partners). Results were heterogeneous for gender differences in depression and for role differences. Higher resilience scores were associated with lower mental distress both in patients and partners. There is some evidence that resilience has a protective effect for mental distress of the spouse.

DISCUSSION AND CONCLUSION

Based on the results on dyadic concordance between patients and partners in mental distress somatic diseases should always be considered from a systemic perspective. Mental distress of both patients and partners requires special attention in psychosocial support, and partnership resources should be taken into account for coping with the disease.