How does marriage protect women with histories of affective disorder from post‐partum relapse?

Interviews were carried out at 36 weeks antenatal with 63 married couples, in 36 of which the woman had a history of affective disorder and in 27 the woman had no previous psychiatric history. The men's attitudes to their wives were assessed using expressed emotion methodology. Also assessed were psychiatric history, neuroticism, satisfaction with the marital relationship and attitudes to sex, pregnancy and parenthood in both the woman and her partner. Women with psychiatric histories who did not relapse in the six months following delivery had partners who were more positive about them than partners of high-risk women who remained well and control women. This effect is explored further by examining which characteristics of the man and which of the woman contributed to his critical and positive comment score. Criticism of his wife was associated with each partner reporting less marital satisfaction and also with the man's psychiatric history. No characteristic of the woman contributed to her partner's criticism. In contrast, the men's positive comments about their wives were associated with the woman's satisfaction with key aspects of her femaleness. Positive husbands had wives were pleased to be pregnant, happy with their pregnant bodies and enjoying the sexual aspect of the marital relationship. In women with psychiatric histories the time which had elapsed since her last psychiatric admission also influenced his positive comments.