Factors related to marital satisfaction in women with major depressive disorder.

Major depressive disorder (MDD) is one of the most common psychiatric disorders with the long-life outbreak of 15% for men and 25% for women (1). MDD is considered the most common psychiatric disorder in Kashan, Iran with the prevalence rate of 8.2% (2). It is predictable that married couples are affected frequently as well as the relationship between the couples. Psychiatric problems usually affect marital satisfaction (3). It is reported that depression affects marital life much more than stress (4). As marital satisfaction decreases, a new scope of family and social problems arise (5, 6). The outbreak of depression among women makes families vulnerable to various damages (7).Along with studies identifying the predictors of marital satisfaction among women with MDD to estimate the patients’ damage, it is crucial to study various approaches to clinical interferences(4). Family theorists explain family coherence by such theories as Systemic theory, Exchange, Conflict, Structural/Functionalism and Symbolic theories. The conflict theory is among the most important theories dealing with family problems. According to this theory, Incapability of family members, especially the wife and the husband, in handling family processes is among the most common types of dissatisfactions (8). Family processes are as follows: 1) religious beliefs;2) coherence and respect among family members;3) confrontation skills;4) decision-making and problem-solving skills;5) communication skills. These skills contribute to family organization and help family members to cope with different conditions (9). Prior studies indicate a relationship between depression and family processes. Reports indicate that depressed people have difficulty in solving a problem/making a decision (10, 11), communication (12), religious beliefs (13), coherence and mutual respect among family members (14) and confrontation skill (15). On the other hand, according to the Marital Discord Model of Depression, depression is a result of the Marital Discord (16). This could be an indication of a strong connection between marital satisfaction and family processes. The significance of social support to help depressed patients increasingly gains importance, especially from the family. Social and family support is an effective help to encounter isolation and failure to enjoy one's life (the two significant symptoms of depression). The social support is reported to have a critical role in decreasing the symptoms of depression (17). It also promotes marital satisfaction (18). Considering the high rate of depression among women, along with the important role of women in family life and marital satisfaction, it is absolutely necessary to investigate and propose interference methods to solve the problems of women with MDD. However, it is critical to use the concepts and structures compatible with the dominant culture in the study population, bearing in mind that the theoretical basis of marital processes along with social support are rich enough to explain psychological interference. Fortunately, the family processes indices in the Family Process Scale (FPS) are compatible with Iranian culture (9). The current study is the first of its kind in Iran which takes into account the function of family processes and social support in predicting marital satisfaction. Moreover, the other concern of this study was finding out the relationship between the demographic characteristics of women with MDD with family processes, social support and their marital satisfaction.