Volk R J, Cantor S B, Steinbauer J R, Cass A R
Department of Family Medicine, University of Texas Medical Branch at Galveston 77555-1123, USA.
Alcohol Clin Exp Res. 1997 Aug;21(5):899-905.
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.
本研究通过SF-36健康调查，考察了初级保健患者中酒精使用障碍及饮酒模式与健康相关生活质量（HRQOL）各维度之间的关联。一个由1333名初级保健患者组成的概率样本完成了酒精使用障碍及相关残疾访谈表，以确定是否存在酒精滥用或依赖障碍，并回答了有关饮酒模式的问题。SF-36的生理和心理健康分量表及主要量表被用作HRQOL的测量指标。符合酒精依赖标准的患者在心理健康分量表及SF-36的每个主要量表上得分较低（HRQOL较差），而与未符合障碍标准的患者相比，酒精滥用者未观察到差异。酒精依赖与心理健康功能减退之间的关联是由其与情绪和焦虑障碍的共病所介导的。经常少量饮酒的患者总体HRQOL通常比其他饮酒组的患者更好。暴饮者和经常大量饮酒者在角色功能和心理健康方面得分明显较低。与近期关于初级保健中心理健康问题的研究不同，酒精使用障碍和饮酒模式似乎对患者的HRQOL有适度影响。不过，这些影响因功能维度、是否存在酒精依赖而非滥用以及饮酒模式而异。诸如SF-36健康调查等HRQOL综合测量指标可能为有饮酒问题患者的初级保健干预研究中的治疗效果提供重要指标。
