Recognition of mental health problems in primary care practices.
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Anxiety Disorders↗
Biomedical subjects
A R Cass
Publications and source records attributed to A R Cass.
Alcohol use disorders, consumption patterns, and health-related quality of life of primary care patients.
This study examined the association of alcohol use disorders and consumption patterns with various dimensions of Health-Related Quality of Life (HRQOL) in primary care patients, as measured by the SF-36 Health Survey. A probability sample of 1333 primary care patients completed the Alcohol Use Disorder and Associated Disabilities Interview Schedule to determine the presence of alcohol abuse or dependence disorders, and answered questions about patterns of alcohol consumption. Physical and Mental Health Component Summaries and primary scales of the SF-36 were used as measures of HRQOL. Patients meeting criteria for alcohol dependence scored lower (poorer HRQOL) on the Mental Health Component Summary and each primary scale of the SF-36, whereas no differences were observed for alcohol abusers compared with patients not meeting criteria for a disorder. The association of alcohol dependence with diminished mental health functioning was mediated by its co-occurrence with mood and anxiety disorders. Patients who drank in a Frequent, Low-Quantity pattern generally had better overall HRQOL than patients from other consumption groups. Binge drinkers and Frequent, High-Quantity Drinkers showed markedly lower scores in the areas of Role Functioning and Mental Health. In contrast to recent studies of mental health problems in primary care, alcohol use disorders and consumption patterns seem to have a modest impact on patients' HRQOL. These effects, though, vary by dimension of functioning, the presence of alcohol dependence rather than abuse, and pattern of alcohol consumption. Global measures of HRQOL such as the SF-36 Health Survey may provide important indicators of treatment effectiveness in primary care intervention studies for patients with drinking problems.
Activities of Daily Living↗
Preferences of husbands and wives for prostate cancer screening.
The benefits of screening for prostate cancer are uncertain. Outcomes of treatment are particularly important to couples because they challenge the most intimate aspects of a couple's relationship. This study used clinical decision analysis to explore the preferences of 10 couples for prostate cancer screening. The decision-analytic model found that 7 of 10 husbands preferred the no screening strategy, while 9 of 10 wives preferred screening for their husbands. Wives associated little burden with complications of treatment, preferring to maximize their husbands' quantity of life regardless of complications. The issue of who is the decision maker is paramount in the case of prostate cancer screening. Optimal screening strategies may differ for husbands and wives. Guidelines for prostate cancer screening and management should consider assessing preferences on an individual couple basis.
Adult↗