Sixty-eight patients on hospital dialysis and their spouses were studied to compare their levels of adjustment and to examine gender differences. Two measures were used: BSI for psychological distress and PAIS for psychosocial adjustment to dialysis. High scores of psychological distress and adjustment problems were found both for patients and their spouses, with high correlations between the partners. Female patients and their husbands had higher scores than male patients and their wives respectively, and in some areas the husbands of female patients reported even more problems than the male patients. Clinical and theoretical conclusions are discussed.