Improving marital quality in women with medical illness: integration of evidence-based programs into clinical practice.

Good marital quality (MQ) is associated with better outcomes in many medical illnesses, especially for women. However, improved outcome is only apparent when MQ is measured across a range of marital functioning and when it is statistically described as either good or poor functioning. This article describes the biological processes that have been shown to underlie this relationship and reviews the influence of MQ on patient outcomes in cardiovascular disease. Studies of interventions to improve MQ vary in level of sophistication, depending on the skill of the provider. This article describes successful evidence-based interventions and the skill sets associated with those interventions. In daily clinical practice, psychiatrists can assess MQ by using the Global Assessment of Relational Functioning (GARF) scale and by asking questions about several dimensions of functioning. Understanding how to apply findings from family research concerning outcomes of medical illness is especially important for psychiatrists who practice psychosomatic medicine. This article outlines how such findings can be applied in clinical practice.