Family structure, marital adjustment, and intimacy in patients referred to a consultation-liaison service.

Patients with chronic physical symptoms of obscure etiology who are referred to a psychiatric consultation service demonstrated characteristic differences in their marital adjustment and family structure when compared with nonpatient controls. Although marital adjustment, as perceived by patient and spouse, was similar to that of nonpatient couples and an absence of overt conflict was demonstrated, the marriages of patients were characterized by specific incompatibilities in intimacy, socializing, and initiative. The family structure also demonstrated a preoccupation with relationships within the family, with resultant isolation from extrafamilial social contacts, and a lack of problem solving ability. The study suggests that the level of intimacy in a marriage may be a predisposing vulnerability risk factor and an influence on illness behavior, or a perpetuating factor in the sick role assumed by at least some hospitalized patients. Finally, the study suggests that marital assessment may have value in the evaluation of patients with chronic physical complaints of obscure etiology.