Self-esteem, optimism and perceived control influence depression in stroke survivors and their spouse caregivers—who should be treated together, according to research presented at the American Stroke Association's International Stroke Conference 2013.

Researchers, who analyzed 112 depressed up to 8 weeks after and their spouses, found self-esteem and optimism influenced each partners' depression.

"We usually have been focused on the outcome of the stroke survivor, but we found that the self-esteem and optimism of the spouse is related to the patient's depression," said Misook Chung, Ph.D., R.N., study author and Associate Professor in the University of Kentucky's College of Nursing in Lexington, Ky. "When the spouse has a high level of self-esteem and optimism, the patient has lower levels of depression."

The impact of spouses on patients' depression has been often ignored, Chung said. "This is an innovative and early analysis that considers the and their caretaker spouses as a unit, not individually."

Researchers drew the cross-sectional study population from four hospitals in Indianapolis. The patients were 66 percent men (average 62 years) and their caregivers were 66 percent women (average 60 years). They used four different questionnaires to assess depression, self-esteem, optimism and perceived control: Patient's Health Questionnaire, Rosenberg Self-Esteem Sale, Revised Life Orientation Test, and Sense of Control Scale.

Depression is common in survivors and in their spouse caregivers, researchers said. The interdependent relationship among the pair in means that improving depression may depend on each partner's characteristics.

"Intervention needs to be given not only to the patient but to the caregiver spouse to maximize the patient's outcome," Chung said. "Maintaining an optimistic and positive view is very important not only for the patient but for the caregiver spouse so that quality of care for the patient can be improved."

Provided by American Heart Association