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Familial Clinical Patterns: I. Reported Symptoms and Signs in the Dentist and His Wife
Published in Geriatrics, Vol. 25, pp. 123-126, February 1970.
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Earlier reports have shown interesting relationships in psychological complaints,1 blood glucose,2 serum cholesterol,3 and the frequency of clinical findings in married couples.4 It is anticipated that this approach may shed additional light on the environmental influences in the genesis of disease. This report is designed to reanalyze the clinical findings4 in married couples in a larger sample. Specifically, an attempt will be made to answer the following questions: [1] What is the relationship between reported symptoms and signs in married couples? [2] How does the husband-wife correlation compare with the frequency of complaints in the husband versus those in an age-paired unrelated female group? [3] What conclusions may be drawn from these two sets of relationships?
Method of Investigation
A total of 345 persons participated in the study. These individuals are participants in a multiphasic screening program conducted in Los Angeles under the auspices of the Southern California Academy of Nutritional Research, in Columbus under the aegis of the Ohio Academy of Clinical Nutrition, and in Florida under the sponsorship of the Southern Academy of Clinical Nutrition. Specifically, there were 115 dental practitioners, 115 wives, and 115 women (wives of other dentists) who were age-paired with the wives. The age patterns are summarized in Table 1.
Table 1–Age distribution of dental practitioners, wives, and unrelated women
Each subject completed the Cornell Medical Index Health Questionnaire (CMI).5 This is a self-administered form consisting of 195 questions. For purposes of this analysis, the total number of affirmative responses was recorded for each subject. Table 2 summarizes the CMI responses. It may be noted that the women (both the wives and the unrelated women) reported more affirmative answers than were reported by the men.
Table 2–Distribution of responses to Cornell Medical Index Health Questionnaire (CMI)
Results
Question 1. In order to resolve the first question, correlation coefficients were performed for the husband versus the wife (Table 3). It will be observed that there is a statistically significant correlation coefficient (r = +0.354, p < 0.01). Hence, in answer to the first question, the frequency of symptoms and signs (total CMI affirmative responses) is similar in the married couples.
Table 3–Correlation coefficients of CMI responses
Question 2. Women who were age-paired against the wives were used in the study. The correlation coefficient between the husband and the unrelated woman is not statistically significant (r = -0.035, p > 0.05). Hence, in answer to the second question, there is no significant relationship between symptom-sign frequencies (total CMI yes responses) in men and women unrelated by marriage.
Discussion
Within the limits of this experiment, the frequency of symptoms and signs in married couples exhibits a statistically significant correlation. However, this does not exist when the husband is compared with an unrelated, age-paired woman.
The question arises as to whether men and women with common health backgrounds select each other as husband and wife. To resolve this question, the groups were subdivided equally into two age categories. Thus, one group of men ranged from under 30 through 40 years of age and the other group from 41 years upward.
Question 3. An analysis of the symptoms and signs (total CMI yes responses) in the husband and the wife reveals that in the younger group there is a statistically significant correlation (r = +0.264, p < 0.05). However, in the older group, the correlation coefficient (r = +0.412) is much higher. Thus, during the early years of marriage, there is a relationship between reported symptoms and signs in the husband and the wife. This may indicate a low degree of interselectivity by men and women with a similar health status. However, as the marriage matures, which can be interpreted to mean more years of living together, the symptom-sign frequencies become more alike. To further corroborate these findings, the age factor is not significant between the husband and the unrelated woman in either group (Table 3). Parenthetic mention should be made that the frequency of findings is similar in the younger (< 39 years) female groups (r = +0.378, p < 0.01). However, this relationship is lost with advancing age (39+ years), as shown by an r = -0.099 and p> 0.05.
The evidence suggests that, as couples live together longer, their complaint frequencies become more alike. This would indicate that environmental factors may be playing a role. Environmental factors are effective in many forms, such as psychic stress and dietary and social habits (tobacco, alcohol). It is noteworthy that the findings described here for the frequency of complaints are very similar to those reported earlier, with psychic complaints,1 blood glucose,2 serum cholesterol,3 and the frequency of clinical complaints in a smaller group.4
Summary
One hundred fifteen dental practitioners, 115 wives, and 115 women (wives of other dentists) who were age-paired with the wives were studied in terms of the frequency of reported symptoms and signs. The evidence suggests that there is a statistically significant correlation coefficient only in the married couples. Within the limits of this study, the evidence indicates that this relationship becomes more similar only with the increasing number of years together.
References Cited:
- Cheraskin, E., and Ringsdorf, W. M., Jr.: “Familial factors in psychic adjustment.” J. Amer. Geriat. Soc. 17:609, 1969.
- Cheraskin, E., Ringsdorf, W. M., Jr., Setyaadmadja, A. T. S. H., Barrett, R. A., Sibley, G. T., and Reid, R. W.: “Environmental factors in blood glucose regulation.” J. Amer. Geriat. Soc. 7:823, 1968.
- Cheraskin, E., and Ringsdorf, W. M., Jr.: “Familial biochemical patterns. I. Serum cholesterol in the dentist and his wife.” J. Amer. Dent. Ass. In press.
- Cheraskin, E., and Ringsdorf, W. M., Jr.: “Frequency of reported symptoms and signs in the dentist and his wife.” Geriatrics 23:158, 1968.
- Brodman, K., Erdman, A. J., Jr., and Wolff, H. G.: Cornell Medical Index Health Questionnaire. New York: Cornell University Medical College, 1949.