Objective. In this study we examined the differences in perceptions of the patient's health status between rheumatoid arthritis (RA) patients and their spouses, and correlates of these differences with pa-tients' and spouses' well-being. Methods. A sample of 188 couples with one member receiving treatment for RA were selected from the rheumatology clinics in Twente, The Netherlands. The mean age of both RA patients and spouses was 56 years. Respondents completed questionnaires, including estimations of both patients and spouses on the patient's functional disabilities and pain, and scales on affect and marital commitment for patients and spouses. Results. Differences in estimations of patients and spouses were considerable. Both over-and un-derestimations of the patient's functional disabilities by the spouse were associated with the patient's poorer mental health status. Overestimations of the patient's functional disabilities were associated with poorer mental health among spouses. Conclusion. It is essential that any support intended by the spouse is in accordance with the pa-tient's needs. If the patient's condition is misper-ceived by the spouse, this can lead to ineffective and inappropriate support being given.