RESUMEN
BACKGROUND: Chronic heart failure (HF) is associated with psychologic distress for patients and their spouses. Although research indicates that a patient's distress can influence the course of illness, less is known about possible effects of a spouse's distress on the patient or of a patient's distress on the health of the spouse. METHODS AND RESULTS: Baseline home interviews of 60 patients with HF (43 men, 17 women) and their spouses included assessments of each partner's psychologic distress (Hopkins Symptom Checklist-25) and perceived general health (Short Form-36 Questionnaire), as well as severity of patients' HF symptoms. We repeated the health and HF-symptom assessments in follow-up interviews 6 months later. As hypothesized, the spouse's distress at baseline predicted an unfavorable course of patients' HF symptoms and general health over the next 6 months, independently of the patient's own baseline distress. There were no prospective effects of the patient's distress on the spouse's health, however, suggesting that partner distress had asymmetric health consequences for patients and spouses. CONCLUSION: The results complement other evidence linking marital quality to the course of HF and highlight the importance of looking beyond the patient to improve prediction of health outcomes.