By: Mark de la Hey
Spring 2009, Vol 12 No 3
Happiness linked to happiness of one’s social contacts
A person’s happiness largely depends on the happiness of the people with whom they are connected, according to research from the University of California in San Diego. Using data on 4,739 individuals from the Framingham Heart Study, researchers assessed social networks and measures of happiness over a 20-year period from 1983 to 2003. They found that happy people tended to be connected to one another and that clusters of happy and unhappy people could be observed within the larger social network. Happy people were more likely to be found at the centres of social networks and within large clusters of other happy people. Statistical analysis indicated that clusters of happy people resulted from the spread of happiness, not just from a tendency for happy people to associate with one another. When a person becomes happy, that results in a 25 per cent increase in the likelihood that any of their friends living within a mile will be happy. Similar increases in the likelihood of being happy were seen among co-resident spouses (8%), siblings living within a mile (14%), and next-door neighbours (34%). There was little significant effect on more distant friends and on coworkers. These effects could extend through the social network up to three degrees of separation (e.g., to a friend of a friend of a friend). The authors conclude that their results point to the importance of physical proximity in the spread of happiness and indicate that frequency of social contact is more important than depth of contact.
BMJ, December 4, 2008, doi: 337:a2338, doi:10.1136/bmj.a2338. James M. Fowler and Nicholas A. Christakis, Department of Political Science, University of California, San Diego, California.
Bereavement may be closer to major depression than believed
Bereavement does not meet current DSM criteria for a diagnosis of major depression; however, research from the Virginia Commonwealth University Medical School in Richmond, Virginia, indicates that there is little difference between bereavement-related depression and major depression related to other stressful life events. Using a large sample of twins from the Virginia Twin Study of Psychiatric and Substance Use Disorders, researchers identified and interviewed 82 individuals with bereavement-related depression and 224 with depression related to other stressful life events. The two groups did not differ in duration of their depressive episode or in the number of previous episodes. They also did not differ in rates of depressed mood, weight loss, appetite changes, sleep disturbances, psychomotor changes, or difficulty concentrating. However, those with bereavement-related depression exhibited significantly higher rates of loss of interest and fatigue, but lower rates of guilt. Individuals with bereavement-related depression were less likely to seek treatment. The authors assert that bereavement-related depression can cause significant impairment and does respond to treatment. They insist that the similarities between bereavement-related depression and major depression related to other stressful life events “far outweigh their differences,” and that their results make a case for dropping the “bereavement exclusion rule” from DSM-V.
American Journal of Psychiatry, November 2008, v. 165: 1449–1455. Kenneth S. Kendler et al., Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University Medical School, Richmond, Virginia.
Nurses can improve psychiatric inpatients’ quality of life
Nurse interventions can significantly improve the quality of life of patients with schizophrenia in acute psychiatric wards, according to research from the University of Turku in Finland. The findings are based on interviews with 35 inpatients in seven acute psychiatric wards in Finland. Participants had diagnoses of schizophrenia, schizotypal disorder, or delusional disorder. They selected the most important areas of their lives and were asked to describe how nurses provided support in each of these areas and how they should support these areas. Participants emphasized empowering interventions involving discussion, showing an interest, and providing encouragement. They also indicated that they would like nurses to discuss patients’ hopes and dreams more, as well as provide information about illness and care. They also wanted nursing interventions to be based on the patient’s individual needs and expressed dissatisfaction with the many universal rules and regulations that did not take individual needs into account. Although participants indicated that they found their wards peaceful and safe, they reported that they were sometimes frightened by other patients and would welcome efforts to enhance feelings of security. The researchers conclude that shifting the focus of psychiatric nursing to quality of life would benefit patients, and that being aware of what impairs patients’ quality of life would help nurses plan individually tailored interventions.
International Journal of Nursing Studies, November 2008, v. 15: 1598–1606. Anneli Pitkänen et al., Department of Nursing Science, University of Turku, Turku, Finland.
Integrated treatment needed for concurrent disorders
Two new studies of co-occurring substance use and mental health disorders from the Centre for Addiction and Mental Health in Toronto highlight the need for better service integration in the treatment of these disorders. The first study collected data on 9,839 individuals seeking mental health treatment in Ontario. The data showed that 18.5 per cent had co-occurring mental health and substance use disorders. Rates of co-occurring disorders were even higher among young adults (55%), those with personality disorders (34%), and those receiving specialty tertiary inpatient care (28%). Individuals with co-occurring disorders were much more likely to have antisocial and challenging behaviour, more likely to have problems with the law, and had a higher risk of suicide or self-harm. The second study analyzed data on 36,984 Canadians from the 2002 Canadian Community Health Survey: Mental Health and Well-Being. It found that almost two per cent of Canadians have a concurrent disorder. People with mental health disorders had about twice the rate of alcohol use problems compared with those without mental health disorders, and they were three times as likely to have problems with illicit drugs. Conversely, people with substance use disorders were two to three times more likely to have other mental health disorders than those without substance use disorders, and those with substance dependence were five to six times more likely to have a co-occurring mental health disorder. The high rates of concurrent disorders seen in these studies point to the need for all parts of the mental health system to better respond to co-occurring disorders with integrated treatment.
Canadian Journal of Psychiatry, December 2008, v. 53: 800–821. Brian Rush et al., Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health, Toronto, Ontario.