Happiness intervention decreases pain and depression, boosts happiness among primary care patients

The effectiveness and equivalence of different versions of a brief online Best Possible Self (BPS) manipulation to temporary increase optimism and affect

BACKGROUND AND OBJECTIVES

The Best Possible Self (BPS) has been found to be an effective manipulation to temporarily improve optimism and affect. The BPS has been used in different formats. In some versions, participants just write about their best possible future, while in others this is combined with imagery. An imagery only version has not been tested yet. The aim of the current study was to examine the effectiveness of three different versions of the BPS and their equivalence in improving optimism and affect.

METHODS

In an online study format, participants (N = 141) were randomly assigned to one of four conditions: (1) writing and imagery BPS; (2) writing BPS; (3) imagery BPS; and (4) a typical day (TD) control condition.

RESULTS

Results showed that each BPS condition significantly improved optimism (i.e. increased positive future expectancies and decreased negative future expectancies) and affect (i.e. increased positive affect and decreased negative affect). Equivalence testing showed that all online BPS conditions were equivalent in increasing optimism and affect, thereby confirming that both the writing and imagery elements of the BPS can independently from each other increase optimism and positive affect in a healthy population.

LIMITATIONS

Only the immediate effects of the BPS formats on increasing optimism and affect were measured.

CONCLUSIONS

The BPS manipulation can be employed in different ways for potential future exploration, depending on the research question, design and context and/or E-mental health applications for the treatment of individuals suffering from psychological complaints.

Resilience to depression: Implication for psychological vaccination

From the vulnerability perspective, we often ask the question "why someone suffers from depression?" Despite outstanding achievements along this line, we still face high occurrence or recurrence and unsatisfied therapeutic efficacy of depression, suggesting that solely focusing on vulnerability perspective is insufficient to prevent and cure depression. Importantly, although experiencing same adversity, most people do not suffer from depression but manifest certain resilience, which could be used to prevent and cure depression, however, the systematic review is still lack. Here, we propose the concept "resilience to depression" to emphasize resilient diathesis against depression, by asking the question "why someone is exempted from depression?" Research evidence of resilience to depression has been reviewed systematically: positive cognitive style (clear purpose in life, hopefulness, et al.), positive emotion (emotional stability, et al.), adaptive behavior (extraversion, internal self-control, et al.), strong social interaction (gratitude and love, et al.), and neural foundation (dopamine circuit, et al.). Inspired by these evidence, "psychological vaccination" could be achieved by well-known real-world natural-stress vaccination (mild, controllable, and adaptive of stress, with help from parents or leaders) or newly developed "clinical vaccination" (positive activity intervention for current depression, preventive cognitive therapy for remitted depression, et al.), both of which aim to enhance the resilient psychological diathesis against depression, through events or training. Potential neural circuit vaccination was further discussed. This review calls for directing attention to resilient diathesis against depression, which offers a new thinking "psychological vaccination" in both prevention and therapy of depression.

Development of a comprehensive flourishing intervention to promote mental health using an e-Delphi technique

BACKGROUND

Although observational studies have already shown promising results of flourishing, a broader concept of health based on positive psychology, there is still a gap in the literature regarding studies that combine different topics of flourishing in a single intervention.

OBJECTIVES

To develop a comprehensive and integrate intervention based on positive psychology gathering different topics of flourishing to improve mental health outcomes in individuals with depressive symptoms.

METHODS

The following steps were performed: (1) a comprehensive literature review; (2) the designing of a 12-session group intervention based on the values, virtues, and topics of flourishing; (3) assessment of the rationale, coherence, and feasibility by a panel of healthcare professionals answering semi-structured questions, and (4) application of an e-Delphi technique including mental health experts to reach a consensus of at least 80% for each item of the protocol.

RESULTS

A total of 25 experts participated in the study, 8 in the panel with semi-structured questions and 17 in the e-Delphi technique. A three-round e-Delphi technique was required to reach a consensus for all items. In the first round, a consensus was reached for 86.2% of the items. The remaining items (13.8%) were either excluded or reformulated. In the second round, a consensus was not obtained on one item, which was reformulated and approved in the third round. Qualitative analyses of the open questions were performed and suggestions for the protocol were considered. The final version of the intervention was composed of 12 weekly group sessions with 90-min each. The topics included in the intervention were physical and mental health, virtues and character strengths, love, gratitude, kindness, volunteering, happiness, social support, family, friends and community, forgiveness, compassion, resilience, spirituality, purpose and meaning of life, imagining the "best possible future," and flourishing.

CONCLUSION

The flourishing intervention was successfully developed using an e-Delphi technique. The intervention is ready to be tested in an experimental study to verify its feasibility and effectiveness.

Temporal relationships between changes in depression and suicidal ideation: A mediation analysis in a randomized double-blinded clinical trial

OBJECTIVES

There is a considerable debate regarding the possible dependence between depression and suicidal ideation treatments. The present study used a novel mediation approach in a randomized comparison of pharmacotherapy and combined therapy to explore whether depressive symptoms mediate the association between treatment and suicidal ideation and whether it depends on the treatment condition.

DESIGN

This study is a randomized, controlled, parallel group (1:1), clinical trial using a novel mediation approach for longitudinal data. Latent difference score modelling was utilized to investigate whether changes in depressive symptoms drive subsequent changes in suicide ideation.

METHOD

Participants were 94 depressive suicidal outpatients who were assessed regarding depressive symptoms and suicidal ideation over the course of an experiment (0-2-7 months). Direct and indirect associations between (change in) depressive symptoms and (change in) suicidal ideation were explored using Pearson's correlations and latent difference score model.

RESULTS

The results showed that depression treatment affects not only suicidal ideation directly but also its influence on suicidal ideation occurs via improvement in depressive symptoms. It was found a more significant effect of combining pharmacotherapy and PPT (in comparison with the pharmacotherapy alone) on the early and late improvements of suicidal ideation (Δ 0-2 and Δ 2-7) via the early improvement of depressive symptoms (Δ 0-2).

CONCLUSIONS

The findings indicate that changes in depressive symptoms preceded changes in suicidal ideation. Our results highlighted that improving depressive symptoms could be a primary target in treating patients with depression experiencing suicidal thoughts.

The effect of COVID-19 uncertainty on internet addiction, happiness and life satisfaction in adolescents

This study aimed to determine the effects of the events during the COVID-19 epidemic on adolescents' levels of intolerance of uncertainty, internet addiction, happiness, and life satisfaction. Structural Equation Modeling was used in the analysis of the data. Adolescents' internet use increased during the epidemic process. It was found that COVID-19 events increased intolerance of uncertainty, and negatively affected internet addiction and happiness (p < 0.001). In this process, internet addiction and happiness is a mediator (p < 0.001). It is recommended to monitor adolescents' internet use during the COVID-19 process and to provide information about COVID-19.

The Relationship between Children's School Adaptation, Academic Achievement, Happiness, and Problematic Smartphone Usage: A Multiple Informant Moderated Mediating Model

The school environment is a primary realm of life for school-aged children and thus their adaptation to school and academic performance may affect their degree of happiness. The age of smartphone users has declined, and problematic smartphone usage has widely expanded such that young children are also affected by such devices. This study assessed adaptation to school, academic achievement, problematic smartphone usage, and general happiness in a panel data sample of 695 Korean 10-year-old children and their teachers and mothers, and a moderated mediation model of these variables was tested. Results revealed that school adaptation affected general happiness of children through academic performance, and problematic smartphone usage demonstrated significant moderating effects on the relationship between school adaptation and academic achievement. Specifically, in children with a high level of adaptation to school life, the difference in problematic smartphone usage did not affect academic performance. However, lower level of adaptation led to greater differences in academic performance depending on problematic smartphone usage, and children with high problematic smartphone usage showed poorer academic performance. This study is meaningful because variables related to adaptation of 10-year-old children were collected from multiple informants. In addition, this study focused on general happiness, a positive factor, as the outcome variable to test the effects of variables related to school and problematic smartphone usage. Limitations include that a causal relationship cannot be examined, and qualitative differences in smartphone usage were not measured.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11482-022-10080-w.

Improving Well-Being in Young Adults: A Social Marketing Proof-of-Concept

Approximately 1 in 5 Australians experience a mental disorder every year, costing the Australian economy $56.7 billion per year; therefore, prevention and early intervention are urgently needed. This study reports the evaluation results of a social marketing pilot program that aimed to improve the well-being of young adults. The Elevate Self Growth program aimed to help participants perform various well-being behaviors, including screen time reduction, quality leisure activities, physical activity, physical relaxation, meditation and improved sleep habits. A multi-method evaluation was undertaken to assess Elevate Self Growth for the 19 program participants who paid to participate in the proof-of-concept program. Social Cognitive Theory was used in the program design and guided the evaluation. A descriptive assessment was performed to examine the proof-of-concept program. Considerations were given to participants’ levels of program progress, performance of well-being behaviors, improvements in well-being, and program user experience. Participants who had made progress in the proof-of-concept program indicated improved knowledge, skills, environmental support and well-being in line with intended program outcomes. Program participants recommended improvements to achieve additional progress in the program, which is strongly correlated with outcome changes observed. These improvements are recommended for the proof-of-concept well-being program prior to moving to a full randomized control trial. This paper presents the initial data arising from the first market offerings of a theoretically mapped proof-of-concept and reports insights that suggest promise for approaches that apply Social Cognitive Theory in well-being program design and implementation.

Exploring the Reciprocal Relationships between Happiness and Life Satisfaction of Working Adults-Evidence from Abu Dhabi

This paper examines the relationships between a range of well-being factors and two commonly used subjective well-being measures-happiness and life satisfaction. Data from the second cycle of the Quality of Life (QoL) Survey in Abu Dhabi were used, which included 32,087 working adults. The well-being factors included in the analysis covered various aspects of life themes: income and jobs, work-home balance, health and physical activities, social and community services, living environment, and family/friends' relationships and connections. Using standardized data, path analysis yielded an optimal path model that suggested the presence of a reciprocal relationship between happiness and life satisfaction. In addition, the final model suggested that four variables-job satisfaction, mental health, satisfaction with relationships with people, and the size of the social support network-had direct effects on happiness and life satisfaction. The model also identified three variables-satisfaction with family life, mental health, and job satisfaction-to have the most significant effect on happiness.

Current Progress and Future Directions for Theory and Research on Savoring

As research on savoring has increased dramatically since publication of the book Savoring: A New Model of Positive Experience (Bryant and Veroff, 2007), savoring has gradually become a core concept in positive psychology. I begin by reviewing the evolution of this concept, the development of instruments for assessing savoring ability and savoring strategies, and the wide range of applications of savoring in the psychosocial and health sciences. I then consider important directions for future theory and research. To advance our understanding of how naturalistic savoring unfolds over time, future work should integrate the perceptual judgments involved in not only the later stages of attending to and regulating positive experience (where past research has concentrated), but also the initial stages of searching for and noticing positive stimuli. Whereas most research has investigated reactive savoring, which occurs spontaneously in response to positive events or feelings, future work is also needed on proactive savoring, which begins with the deliberate act of seeking out or creating positive stimuli. To advance the measurement of savoring-related constructs, I recommend future work move beyond retrospective self-report methods toward the assessment of savoring as it occurs in real-time. The development of new methods of measuring meta-awareness and the regulation of attentional focus are crucial to advancing our understanding of savoring processes. I review recent research on the neurobiological correlates of savoring and suggest future directions in which to expand such work. I highlight the need for research aimed at unraveling the developmental processes through which savoring skills and deficits evolve and the role that savoring impairments play in the etiology and maintenance of psychopathology. Research is also needed to learn more about what enhances savoring, and to disentangle how people regulate the intensity versus duration of positive emotions. Finally, I encourage future researchers to integrate the study of anticipation, savoring the moment, and reminiscence within individuals across time.

Life goal reconstruction for people with chronic health conditions: Feasibility of a brief internet-based writing intervention using a minimally monitored delivery

Examination of people's narratives after significant life changes revealed that engaging in current and future goal reconstruction was associated with higher levels of well-being while a failure to disengage from "what might have been" was associated with lower levels of well-being. This work led to the development of a life goal writing intervention that has received empirical support with most studies conducted among nonclinical populations. This study aims to assess the feasibility of a brief and minimally monitored internet-delivered writing therapy developed to facilitate life goal reconstruction among adults diagnosed with various chronic health conditions. Sixteen adults showing mild to moderate levels of anxiety or depression were recruited and a single group pretest/post-test design used. The 5-week program is comprised of psychoeducation, five weekly 30-min writing sessions, automated emails and symptom monitoring. Feasibility outcome measures included attrition, treatment adherence, acceptability and preliminary effectiveness. Primary outcome measures were The Patient Health Questionnaire -9 (PHQ-9) and the Generalized Anxiety Disorder -7 (GAD-7). Attrition was low (12%) and adherence high (93%). All but one study completer reported they would recommend the program. Mixed effects models revealed a significant and large reduction from pre-treatment to post-treatment on the PHQ-9 and GAD-7 and remission rates of 67% and 64% respectively. These findings suggest that it would be feasible to proceed to a larger trial. The brief duration of the intervention combined to a minimally monitored delivery may lend itself to implementation in routine clinical care milieus such as hospital settings.

Designing an eHealth Well-Being Program: A Participatory Design Approach

In recent years, the relevance of eHealth interventions has become increasingly evident. However, a sequential procedural application to cocreating eHealth interventions is currently lacking. This paper demonstrates the implementation of a participatory design (PD) process to inform the design of an eHealth intervention aiming to enhance well-being. PD sessions were conducted with 57 people across four sessions. Within PD sessions participants experienced prototype activities, provided feedback and designed program interventions. A 5-week eHealth well-being intervention focusing on lifestyle, habits, physical activity, and meditation was proposed. The program is suggested to be delivered through online workshops and online community interaction. A five-step PD process emerged; namely, (1) collecting best practices, (2) participatory discovery, (3) initial proof-of-concept, (4) participatory prototyping, and (5) pilot intervention proof-of-concept finalisation. Health professionals, behaviour change practitioners and program planners can adopt this process to ensure end-user cocreation using the five-step process. The five-step PD process may help to create user-friendly programs.

Patient experiences of psychological therapy for depression: a qualitative metasynthesis

BACKGROUND

Globally, national guidelines for depression have prioritised evidence from randomised controlled trials and quantitative meta-analyses, omitting qualitative research concerning patient experience of treatments. A review of patient experience research can provide a comprehensive overview of this important form of evidence and thus enable the voices and subjectivities of those affected by depression to have an impact on the treatments and services they are offered. This review aims to seek a comprehensive understanding of patient experiences of psychological therapies for depression using a systematic and rigorous approach to review and synthesis of qualitative research.

METHOD

PsychINFO, PsychARTICLES, MEDLINE, and CINAHL were searched for published articles using a qualitative approach to examine experiences of psychological therapies for depression. All types of psychological therapy were included irrespective of model or modes of delivery (e.g. remote or in person; group or individual). Each article was assessed following guidance provided by the Critical Appraisal Skill Programme tool. Articles were entered in full into NVIVO and themes were extracted and synthesized following inductive thematic analysis.

RESULTS

Thirty-seven studies, representing 671 patients were included. Three main themes are described; the role of therapy features and setting; therapy processes and how they impact on outcomes; and therapy outcomes (benefits and limitations). Subthemes are described within these themes and include discussion of what works and what's unhelpful; issues integrating therapy with real life; patient preferences and individual difference; challenges of undertaking therapy; influence of the therapist; benefits of therapy; limits of therapy and what happens when therapy ends.

CONCLUSIONS

Findings point to the importance of common factors in psychotherapies; highlight the need to assess negative outcomes; and indicate the need for patients to be more involved in discussions and decisions about therapy, including tailoring therapy to individual needs and taking social and cultural contexts into account.

Direct and Indirect Effects of Trait and State Gratitude on Health-Related Quality of Life in a Prospective Design

Gratitude has been consistently linked to well-being, but its influence on health-related functioning is not well understood. Furthermore, research suggests the need to differentiate between-person and within-person effects of personality characteristics, and research on gratitude and health has not typically done so. This prospective study aimed to (1) differentiate the unique effects of trait and state gratitude on health-related quality of life (HRQoL) and (2) test state gratitude as a mediator between baseline trait gratitude and subsequent HRQoL. Undergraduate participants (N = 141) completed a trait gratitude measure at baseline and then repeated measures of weekly state gratitude and HRQoL over eight weeks. Multilevel models examined baseline trait gratitude, state gratitude averaged across the study (person aggregate) as between-person individual differences, and within-person variability in state gratitude (person-centered) as predictors of HRQoL, as well as the indirect effect of trait gratitude on HRQoL via state gratitude. Greater aggregate and person-centered state gratitude each predicted higher HRQoL. Baseline trait gratitude did not have a significant direct effect but prospectively predicted higher HRQoL via higher weekly state gratitude. Results suggest that understanding effects of gratitude on health-related perceptions requires accounting for both between-person individual differences and within-person fluctuation in state gratitude.

What Interventions Improve Outcomes for the Patient Who Is Depressed and in Pain?

SPECIFIC CLINICAL ISSUE

The purpose of this clinical consultation is to offer nurses evidence-based strategies to provide holistic care to their patients with comorbid depression and pain. The combination of depression and pain is common and, if not managed effectively, has negative outcomes. Treatment-resistance is one negative outcome. The worst-case scenario for unrelieved depression and/or pain is suicide.

MAJOR PRACTICE RECOMMENDATIONS BASED ON BEST EVIDENCE

Antidepressants, particularly duloxetine, have had efficacy for pain and depression. Cognitive behavioral therapy, an evidence-based treatment for depression, has been found to decrease pain. Examples of additional interventions include exercise, relaxation techniques, mindfulness, and music. Providing holistic nursing care and working with other disciplines optimizes more effective management of these co-occurring conditions.

Using the Awareness, Motivation, Skills, and Opportunity Framework for Health Promotion in a Primary Care Network

Purpose. To use the Awareness, Motivation, Skills, and Opportunity (AMSO) framework as a foundation for service delivery in a primary care network (PCN). Method. The AMSO framework (awareness, motivation, skills, opportunity) was integrated into PCN program design: Health Basics (8 weeks with monthly follow-up) focused on healthy living and Happiness Basics (6 weeks) used positive psychology. Evaluation included quality of life (QofL) and participant experience; weight, body mass index, and waist circumference were included for Health Basics. Data were analyzed using descriptive statistics, paired t tests, and thematic analysis. Setting. PCN in western Canada with midsized urban center and surrounding areas. Participants. Health Basics-adults with or at risk for chronic disease (n = 103). Happiness Basics-adults with depression, languishing, or flourishing (n = 124). Results. Changes were evident in weight loss, body mass index, waist circumference, and QofL (p < .05) for Health Basics participants. The participants also reported being more active, eating healthier, having a more positive mind-set, and having confidence in making lifestyle changes. Happiness Basics participants' QofL improved in all domains (p < .05) except the physical summary score (p = .079). Happiness participants described positive experiences and learned new skills. Conclusion. The AMSO framework was successfully implemented in our PCN. Recommendations are included to improve program effectiveness and use.

Long-lasting antinociceptive effects of green light in acute and chronic pain in rats

Treatments for chronic pain are inadequate, and new options are needed. Nonpharmaceutical approaches are especially attractive with many potential advantages including safety. Light therapy has been suggested to be beneficial in certain medical conditions such as depression, but this approach remains to be explored for modulation of pain. We investigated the effects of light-emitting diodes (LEDs), in the visible spectrum, on acute sensory thresholds in naive rats as well as in experimental neuropathic pain. Rats receiving green LED light (wavelength 525 nm, 8 h/d) showed significantly increased paw withdrawal latency to a noxious thermal stimulus; this antinociceptive effect persisted for 4 days after termination of last exposure without development of tolerance. No apparent side effects were noted and motor performance was not impaired. Despite LED exposure, opaque contact lenses prevented antinociception. Rats fitted with green contact lenses exposed to room light exhibited antinociception arguing for a role of the visual system. Antinociception was not due to stress/anxiety but likely due to increased enkephalins expression in the spinal cord. Naloxone reversed the antinociception, suggesting involvement of central opioid circuits. Rostral ventromedial medulla inactivation prevented expression of light-induced antinociception suggesting engagement of descending inhibition. Green LED exposure also reversed thermal and mechanical hyperalgesia in rats with spinal nerve ligation. Pharmacological and proteomic profiling of dorsal root ganglion neurons from green LED-exposed rats identified changes in calcium channel activity, including a decrease in the N-type (CaV2.2) channel, a primary analgesic target. Thus, green LED therapy may represent a novel, nonpharmacological approach for managing pain.

Psychotic-like experiences and happiness in the English general population

BACKGROUND

Psychotic-like experiences (PLEs) have been associated with a variety of adverse outcomes but how they affect happiness in individuals with PLE is unknown. Thus, the aim of the study was to assess the association between PLEs and happiness, and the factors that may influence this association.

METHODS

Nationally representative data from the 2007 Adult Psychiatric Morbidity Survey including adults aged ≥ 16 years was analyzed. The Psychosis Screening Questionnaire was used to assess past 12-month PLE. Individuals who endorsed at least one of the following were considered to have any PLE: thought control, paranoia, strange experiences, auditory hallucinations. Happiness (3-point scale) was assessed with a validated question with higher scores indicating lower levels of happiness. The association between PLE and happiness was assessed by multivariable ordinal logistic regression. Mediation analysis was also performed.

RESULTS

Among the 7363 individuals included in the analysis, the prevalence of any PLE increased with decreasing levels of happiness [very happy (2.3%), fairly happy (5.4%), not too happy (14.9%)]. This was also shown in the multivariable analysis adjusted for sociodemographic factors and stressful life events (from very happy to not too happy: OR = 2.41; 95%CI = 1.86-3.12). Mediation analysis showed that anxiety disorders explained the largest proportion of the association (38.8%) followed by depressive episode (28.5%), insomnia (21.9%), disability (16.5%), pain (12.5%), social support (10.0%), and physical health conditions (6.0%).

LIMITATIONS

The cross-sectional design limits causal inference.

CONCLUSION

Interventions to identify and address conditions that may have a negative impact on happiness in individuals with PLE may be important to improve their well-being.

The Application of Positive Psychotherapy in Mental Health Care: A Systematic Review

OBJECTIVE

Positive psychotherapy (PPT) stems from the positive psychology movement and is a multicomponent model promoting therapeutic change by developing engagement, pleasure, and meaning. There is some evidence it is effective for depression. PPT is recommended as a flexible model that can be applied to other patient groups alongside other treatments approaches. However, it remains unclear which of the many components are applied. The study aimed to identify how PPT is applied in mental health care.

METHOD

We systematically searched online databases, including Medline, Embase, PsycINFO, British Nursing Index, Cumulative Index of Nursing and Applied Health, and Cochrane registers (CENTRAL), and completed complementary hand and citation searches. Narrative synthesis was used for analysis.

RESULTS

A total of 12 papers (from 9 studies) widely applied some PPT components (e.g., blessings journal, character strengths) and scarcely applied others (e.g., satisficing plan or family strengths tree). However, papers poorly described the intervention and rationale for applying components.

CONCLUSION

Given the lack of rationale for applying PPT, further research is needed to establish which components are acceptable and feasible for use in different patient groups and settings.

Perspectives on Living With Fibromyalgia

Perceptions of people living with chronic illness change over time, contributing to health-related stress that necessitates coping skills. Paterson's shifting perspectives model provides an explanation of chronically ill people's variations in attention to their symptoms. In this qualitative study, 20 people with fibromyalgia living in a rural setting were interviewed in 2013 with the aim of gaining insight into their experiences and the meaning-making associated with their chronic condition. Analysis of the interview data categorized five recurrent, or common, themes: experiences of loss, feelings of fear and uncertainty, influence of stress, stigmatization of the disease, and coping through courage. Difficulties attendant to losses, distress, and stigma associated with this chronic condition led the participants to report poor health-related quality of life. The study findings can be useful across clinical settings to nurses and other health care providers in understanding those diagnosed with fibromyalgia and their care needs.

Giving social support to outside family may be a desirable buffer against depressive symptoms in community-dwelling older adults: Japan gerontological evaluation study

Background

Depression is the leading cause of impaired quality of life and burden upon societies. Social supports can buffer against depressive symptoms effectively. The aim of this study is to determine the type of social support to have a positive relationship with depressive symptoms in healthy population.

Methods

11,869 male and 12,763 female residents within the age range of 65–100 were analyzed cross-sectionally with regard to depressive symptoms (evaluated by the Japanese version of the 15-item Geriatric Depression Scale), social supports (four dimensions: giving or receiving, emotional or instrumental), and covariates utilizing data collected by the Japan Gerontological Evaluation Study. Analyzed　participants were GDS scores ≤ 10 and independence in ADL, who could give and receive supports well. Multiple linear models were applied for the analysis.

Results

All supports between husband and wife were significantly associated with lower depressive degrees. In comparison with the differences between receiving and giving supports in predictive effects on depressive degrees, giving social supports to outside family, emotional or instrumental, were associated with fewer depressive symptoms.

Conclusions

There is a possibility that not only supports between husband and wife but giving social supports to outside family accounts for psychological benefits against depression, in addition to supports between husband and wife.

Subjective well-being among primary health care patients

BACKGROUND

The psychological importance of subjective well-being for a healthy life has been well recognized. It is also well known that depressive and anxiety disorders have a negative effect on subjective well-being. The aim of this cross-sectional, descriptive study was to assess the subjective well-being status of a group of primary healthcare patients in relation to socio-demographic characteristics, personal health and mood-status.

METHODS

A total of 284 patients participated in the study. The Oxford Happiness Scale, Life Satisfaction Scale, DASS-42 (Depression, Anxiety and Stress Scales-42) and a questionnaire about socio-demographic characteristics were completed by the participants.

RESULTS

In general, the participants were found to be moderately happy and satisfied with their lives. They had mild levels of depression, anxiety and stress. In terms of happiness, an older age (≥40 years), educated to secondary level or higher and not having depression or anxiety were found to be factors increasing happiness. In terms of life satisfaction, female gender, an older age (≥40 years), educated to secondary level or higher, being single and not having depression were found to increase life satisfaction.

CONCLUSION

Primary healthcare providers should give more importance to the mood status of their patients. Screening for depression and anxiety should be applied at the primary healthcare level because negative mood status is more important than some socio-demographic characteristics in respect of unhappiness and dissatisfaction.