The marital context of depression: research, limitations, and new directions

Despite improved recognition and treatment of mood disorders, understanding the mechanics of the interpersonal context of depressive disorders remains a vital area of scientific research. This paper reviews the findings on the marital context of depression by critically examining available empirical research on marital communication behaviors of depressed individuals. The specificity of the observed communication behaviors to depression versus marital distress or a general medical or psychiatric condition is examined. The paper also reviews the evidence on gender differences in marital communication of depressed individuals, depending on whether the husband or wife is depressed. The second part of the paper critically reviews three dominant interpersonal theories of depression as they refer to marital relationships. We discuss the need for theoretically-guided research and identify methodological and conceptual limitations of the current empirical literature, while highlighting the need for further theory development and refinement. Future interpersonal theories need to better account for depression epidemiology and the gender difference in rates of depression, as well as incorporate ideas from other theoretical perspectives.