In the literature on the marital relationship of psychiatric patients it often has been reported that the healthy spouses may show a considerable degree of psychological distress. 2. A correlation of psychiatric disorders in married couples commonly has been interpreted according to two models: assortative mating and pathogenic interaction, neither of which can sufficiently explain the spousal psychiatric illness correlation. 3. The issue of psychiatric illness in the spouses of patients merits more attention from both researchers and clinicians. A psychiatric illness in one spouse must be understood within the ongoing interaction of the marital relationship.