Conjugopathy is a significant socio-health problem worldwide, due to its major health and psychosocial implications. It refers to a dysfunction of the marital dyad [1], recurrent and persistent difficulties in the interactions between partners in the couple, for which couple therapy appears to be a standard treatment [2]. It manifests itself in many forms and spares no society, even those considered advanced. Any couple can be exposed to it [3], with a higher risk for long-term couples [4]. It should be distinguished from a marital crisis, which is brief and experienced by almost all couples at some point in their relationship [5]. It should also be distinguished from domestic violence, even though it can lead to it [6].

It has been shown that conflicts are an integral part of social life and are not necessarily a bad thing, in that they can appear as opportunities for growth [7]. As such, conflicts are also inevitable in married life [8][9], where they are even described as beneficial [10]. Marital conflicts exist and manifest themselves in diverse ways throughout the world [11]. However, when they become serious, recurrent, unresolved and a source of significant suffering, they deserve special attention.

Despite the reality of conjugopathy, it is not easy to determine its exact prevalence. However, epidemiological indicators such as the divorce rate, domestic violence, infidelity, the rate of dissatisfaction in the couple, marital distress and the ever-increasing demand for couple’s therapy, point to its high prevalence in contemporary society [7]. Some regional estimates are sometimes reported. For example, in France, a survey by the National Institute of Statistics and Economic Sciences on living conditions conducted in 2014-2015 revealed that 1 out of 10 adults, and by gender, 12.7% of women versus 10.5% of men aged 18 to 75, were affected [12].

Similarly, in Canada, a survey conducted in 2020 showed that 30% of married or common-law adults had experienced major marital conflict in the 12 months preceding the survey, and that divorce rates continued to rise, reaching nearly 40% in recent decades [13].

Ivory Coast, a Sub-Saharan African country, is also affected. Despite the lack of national statistics, it can still be argued that conjugopathy is a worrying reality, considering the scale of the divorce rate alone, estimated at 40.7% in June 2022, by the civil registry’s statistical yearbook.

The sources of conflict within couples are countless. Among the common sources are frustrations and disappointments, jealousy, incompatibilities of taste, the more or less intrusive (friendly or hostile) presence of family circles, the vagaries of the spouses’ professional situations and the influence of children [14], unmet expectations, intimacy, financial difficulties, inequalities of power and equity, and family and domestic responsibilities [15].

Similarly, conjugopathy has significant repercussions not only on spouses [8], more so on women than men [12], and the marital relationship [16][17]; but also, and above all, on children [18][19], on the family, and on society as a whole. Indeed, if being in a couple is a determinant of the partners’ well-being [20], then dysfunctions within the couple will systematically lead to a decline in the partners’ mental and physical health [16].

Despite the existence of family and community support networks, state structures, and private practices working in the prevention and treatment of couple-related pathologies, marital dysfunction persists and is now the subject of an increasing demand for consultations in mental health services. However, it is very poorly documented in social science research, even though the issue of couples concerns virtually everyone from a certain age, regardless of their sex, sexual orientation, or social status [14]. The few existing studies have not sufficiently explored the psychosocial experiences of spouses, particularly in the social context of Abidjan. This concern forms the basis of the present study, which aims to answer the following question:

What is the psychosocial experience of spouses seeking help for conjugopathy in Abidjan?

This study is grounded in attachment theory [21], which is based on the premise that the quality of the attachment relationship built since childhood influences the quality of all future social relationships.

It rests on the general hypothesis that conjugopathy affects the psychosocial experience of spouses seeking help in Abidjan.

The overall objective of this study is to examine the psychosocial experience of spouses seeking help for marital dysfunction in Abidjan. Specifically, it aims to determine the bio-sociodemographic characteristics of these spouses, describe their marital history and the characteristics of their marital problems, and explore their feelings and coping mechanisms before their consultation in the Addictology and Mental Hygiene Department.

The results of the study are structured around three points. The first concerns the presentation of the bio-sociodemographic characteristics of the respondents, the second, their marital history and the characteristics of their marital pathology, and the third and last, their psychosocial experience.

The objective of this study is to examine the psychosocial experience of spouses seeking help for conjugopathy in Abidjan. To this end, we focused on presenting the bio-sociodemographic characteristics of their marital dysfunction and examining their psychosocial experience. The results of our study indicate a negative psychosocial experience characterized by strong negative emotions such as sadness, shame, pain, fear, and anger, on the one hand, and inappropriate coping mechanisms such as seeking mediation from unqualified relatives; using medication and alcohol; and engaging in suicidal thoughts and attempts to face it on the other hand. Drawing on Bowlby’s attachment theory [21], we can explain these results by the stability of the attachment relationship and its impact on adults’ relational lives, particularly marital relationships. Indeed, marital relationships inevitably give rise to conflicts, the resolution of which is contingent upon a high-quality attachment. Even couples who appear very close are not exempt from conflict due to the biological and cultural differences between the partners. Without a secure attachment style, the resolution of marital conflicts cannot be swift, and these conflicts will persist, become more complex, and evolve over time, depending on the individual characteristics of the spouses, potentially leading to marital dysfunction. Regarding gender for example, the overrepresentation of women in our study suggests that they appear more affected by these marital dysfunctions than men. In reality, they are more emotional and are also culturally permitted to express their suffering, even through tears, whereas men’s upbringing allows them to mask theirs, to never cry in order to demonstrate their virility. As for the age of the spouses surveyed, it ranged from 23 to 48 years old, with half in the 40 - 48 age bracket. This age range often corresponds to a crucial period in married life, marked by increased family responsibilities combined with professional demands; this can exacerbate tensions within the couple. All the respondents had also attended school, but educational inequalities influenced their understanding and management of married life. Their professional activities, with the exception of the two who were unemployed, reflected a modest socioeconomic level. This low socioeconomic status can exacerbate marital conflicts due to the increased frustration and resulting insecurity. Regarding religion, 12 of the respondents were Christian, while 08 were Muslim. Although Christianity and Islam are two major religions that contribute to the formation and maintenance of couples, their religious affiliation did not prevent the emergence of marital conflicts, nor did it facilitate their resolution. Concerning the form of marriage, all respondents had entered into customary marriages, including those legally married. Indeed, customary marriage is the socially expected and valued form of union, demonstrating the weight and supremacy of custom over modern law in the economic capital. The duration of the marriage of the spouses surveyed, which ranged from 1 to 15 years or more, also showed that conjugopathy can affect both young and older couples, but with a higher frequency among older couples. As for the reasons for conflicts within the couple, these were varied and, in order of increasing frequency, were infidelity, child-rearing, money management, and refusal intimacy. All of these reasons had a strong impact on the relationship dynamics within the couple, as they signaled a breakdown of trust between spouses.

Our results corroborate those of numerous previous studies, indicating that conflict management style within couples is closely linked to early interactions [22] and that perpetrators of domestic violence have an insecure attachment style [23].

Our results also corroborate those of previous studies which reveal that all couples can be affected by conjugopathy, with a higher risk for older couples [4]; that the sources of tension in the couple are countless and that the most common concern frustrations and disappointments, jealousy, incompatibilities of tastes, the more or less intrusive friendly or hostile presence of family circles, the vagaries of the professional situation of the spouses and the influence of children[14], unmet expectations, intimacy, financial difficulties, inequalities of power and equity, family and domestic responsibilities [15].

Our results are also similar to those of previous studies reporting that women are generally more affected by conjugopathy than men, with higher levels of emotional distress and associated psychosomatic disorders, leading them to report abuse or aggression [12]; or to seek support or mental health services more frequently [24]; and that couples are seeking help at increasingly younger ages and earlier in their relationship [24]. In contrast, men, unlike women, often tend to minimize or conceal their suffering for fear of appearing vulnerable.

Our results are also similar to those of previous studies which show that conjugopathy leads to a decline in the mental and physical health of spouses [16] and suicidal behaviors [25].

However, the study has limitations that warrant attention. Indeed, the small sample size and the qualitative approach used limit the generalizability of our findings. Similarly, the selection of participants from a clinical population rather than the general population, along with the cultural variability of marital dynamics, necessitates a cautious interpretation of our results. Therefore, we suggest future research with larger, more representative samples and a longitudinal approach that considers the cultural context to strengthen the data and inform future interventions. A study on the impact of these interventions on the spouses would be essential. We also suggest that, within mental health services, the skills of caregivers in couple’s therapy be strengthened, and that some specialize in it. With regard to policies, it would be beneficial to reduce the costs of consultations for spouses in distress, and to bring healthcare services closer to couples residing in other urban and rural areas of the country by staffing the health centers located there with qualified caregivers. Finally, we suggest community awareness campaigns on conjugopathy, its manifestations and its psychosocial consequences, organized within communities and involving community, religious, and social leaders.

Conjugopathy is a worrying reality in contemporary couples. It therefore seemed appropriate to address this issue through a research question concerning the psychosocial experiences of affected spouses seeking help in Abidjan. To study the psychosocial experiences of these spouses, this qualitative study was conducted. It took place between September 2^nd and 30 th, 2024, with 20 spouses selected through purposive sampling at the Addiction and Mental Health Service of the National Institute of Public Health in Abidjan. These individuals were submitted to a semi-structured interview. The results indicate that the respondents were of both sexes, with a female predominance (16/20), aged 23 to 48 years, and had a low socioeconomic status. The duration of their unions ranged from 1 to 15 years. Their psychosocial experience was negative, marked by unpleasant emotions to which they had developed inappropriate reactions. However, the small sample size, the qualitative approach used, and the fact that the study was conducted in a clinical population rather than the general population constitute significant limitations. Therefore, we suggest conducting further studies with larger samples to generalize the results.

We also suggest that, within mental health services, the skills of caregivers in couple’s therapy be strengthened, and that some specialize in it. With regard to policies, it would be beneficial to reduce the costs of consultations for spouses in distress, and to bring healthcare services closer to couples residing in other urban and rural areas of the country by staffing the health centers located there with qualified caregivers. Finally, we suggest community awareness campaigns on conjugopathy, its manifestations and its psychosocial consequences, organized within communities and involving community, religious, and social leaders.

All authors have given their consent to publish this article in this Journal.