Depression Treatment: Flourishing Across Europe: Application of a New Conceptual Framework for Defining Well-Being.

Flourishing Across Europe: Application of a New Conceptual Framework for Defining Well-Being.

Filed under: Depression Treatment

Soc Indic Res. 2013 Feb; 110(3): 837-861
Huppert FA, So TT

Governments around the world are recognising the importance of measuring subjective well-being as an indicator of progress. But how should well-being be measured? A conceptual framework is offered which equates high well-being with positive mental health. Well-being is seen as lying at the opposite end of a spectrum to the common mental disorders (depression, anxiety). By examining internationally agreed criteria for depression and anxiety (DSM and ICD classifications), and defining the opposite of each symptom, we identify ten features of positive well-being. These combine feeling and functioning, i.e. hedonic and eudaimonic aspects of well-being: competence, emotional stability, engagement, meaning, optimism, positive emotion, positive relationships, resilience, self esteem, and vitality. An operational definition of flourishing is developed, based on psychometric analysis of indicators of these ten features, using data from a representative sample of 43,000 Europeans. Application of this definition to respondents from the 23 countries which participated in the European Social Survey (Round 3) reveals a four-fold difference in flourishing rate, from 41% in Denmark to less than 10% in Slovakia, Russia and Portugal. There are also striking differences in country profiles across the 10 features. These profiles offer fresh insight into cultural differences in well-being, and indicate which features may provide the most promising targets for policies to improve well-being. Comparison with a life satisfaction measure shows that valuable information would be lost if well-being was measured by life satisfaction. Taken together, our findings reinforce the need to measure subjective well-being as a multi-dimensional construct in future surveys.
HubMed – depression


Osmolality, pH, and Compatibility of Selected Oral Liquid Medications With an Enteral Nutrition Product.

Filed under: Depression Treatment

JPEN J Parenter Enteral Nutr. 2013 Jan 17;
Klang M, McLymont V, Ng N

When selecting medication for feeding tube administration, the liquid formulation is selected, so as to avoid obstructions that may occur from incompletely crushing a solid dosage form. Liquid medications can present issues of intolerance and compatibility when administered via a feeding tube. A predictor of intolerance is the liquid’s osmolarity, and a predicator of compatibility is the liquid’s pH value. This study examines 62 liquid formulations for their osmolality, pH, and physical compatibility with enteral nutrition (EN) formulas. These medications were selected as being the most commonly dispensed liquid medications from our outpatient pharmacy department. This study measures osmolality using freezing point depression. Depending on the dose, the osmotic load of a liquid medication may cause cramping and diarrhea. The pH value is predictive of potential interactions with the EN formula. Many drugs are weak bases and require acidic vehicles for optimal stability. The acidic liquids are especially reactive with enteral formulas that contain intact proteins. The result of this interaction can result in an occlusion of the feeding tube as the proteins form a gel-like clog. This study combined the liquid medication directly with the EN formula to determine the potential for feeding tube occlusion. Some drugs formed a solid mass in the test tube immediately, whereas others only presented granules, which may later contribute to obstructing the feeding tube. The prescriber should be aware of the potential impact of their choice in formulation, both in terms of the gastrointestinal tolerance and potential for interaction with coadministered nutrition.
HubMed – depression


Physical Activity Interventions and Depression in Children and Adolescents : A Systematic Review and Meta-Analysis.

Filed under: Depression Treatment

Sports Med. 2013 Jan 4;
Brown HE, Pearson N, Braithwaite RE, Brown WJ, Biddle SJ

CONTEXT: Evidence suggests chronic physical activity (PA) participation may be both protective against the onset of and beneficial for reducing depressive symptoms. OBJECTIVE: The aim of this article is to assess the impact of PA interventions on depression in children and adolescents using meta-analysis. DATA SOURCES: Published English language studies were located from manual and computerized searches of the following databases: PsycInfo, The Cochrane Database of Systematic Reviews and The Cochrane Central Register of Controlled Trials, Trials Register of Promoting Health Interventions (TRoPHI; EPPI Centre), Web of Science and MEDLINE. STUDY SELECTION: Studies meeting inclusion criteria (1) reported on interventions to promote or increase PA; (2) included children aged 5-11 years and/or adolescents aged 12-19 years; (3) reported on results using a quantitative measure of depression; (4) included a non-physical control or comparison group; and (5) were published in peer-reviewed journals written in English, up to and including May 2011 (when the search was conducted). DATA EXTRACTION: Studies were coded for methodological, participant and study characteristics. Comprehensive Meta-Analysis version-2 software was used to compute effect sizes, with subgroup analyses to identify moderating characteristics. Study quality was assessed using the Delphi technique. RESULTS: Nine studies were included (n = 581); most were school-based randomized controlled trials, randomized by individual. Studies used a variety of measurement tools to assess depressive symptoms. The summary treatment effect was small but significant (Hedges’ g = -0.26, standard error = 0.09, 95% confidence intervals = -0.43, -0.08, p = 0.004). Subgroup analyses showed that methodological (e.g. studies with both education and PA intervention; those with a higher quality score; and less than 3 months in duration) and participant characteristics (e.g. single-gender studies; those targeting overweight or obese groups) contributed most to the reduction in depression. CONCLUSIONS: There was a small significant overall effect for PA on depression. More outcome-focused, high-quality trials are required to effectively inform the implementation of programmes to reduce depressive symptoms in children and adolescents.
HubMed – depression


Treatment Plans And Interventions For Depression And Anxiety Disorders - Leahy

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