title: Health-Related Quality of Life, Treatment Satisfaction, and Costs Associated With Intraperitoneal Versus Subcutaneous Insulin Administration in Type 1 Diabetes The WHO (Ten) Well-Being Index: validation in diabetes. Reliability and validity of the Thai version of the WHO-Five Well-Being Index in primary care patients. Harmful alcohol habits were no more common in a sample of newly sick-listed Swedish women and men compared with a random population sample. Screening for depression in elderly Indian population Cerebrovascular disease and depression symptoms in the cardiovascular health study. Benchmarking network for clinical and humanistic outcomes in diabetes (BENCH-D) study: protocol, tools, and population Evaluation of a Seven-Week Web-Based Happiness Training to Improve Psychological Well-Being, Reduce Stress, and Enhance Mindfulness and Flourishing: A Randomized Controlled Occupational Health Study Workplace Social Capital and Mental Health among Chinese Employees: A Multi-Level, Cross-Sectional Study Pain and quality of life for patients with venous leg ulcers: proof of concept of the efficacy of Biatain-Ibu, a new pain reducing wound dressing. Randomized Placebo-Controlled Trial of a Selective Serotonin Reuptake Inhibitor in the Treatment of Nondepressed Tinnitus Subjects Efficacy of prolonged release melatonin in insomnia patients aged 55–80 years: quality of sleep and next-day alertness outcomes Alcohol withdrawal syndrome: symptom-triggered versus fixed-schedule treatment in an outpatient setting. A 9-week randomized trial comparing a chronotherapeutic intervention (wake and light therapy) to exercise in major depressive disorder patients treated with duloxetine. Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: a randomized, controlled trial. Depressive, anxiety, and somatoform disorders in primary care: prevalence and recognition.
abstract: OBJECTIVE To investigate the effects of continuous intraperitoneal insulin infusion ( CIPII ) compared with subcutaneous insulin on health-related quality of life ( HRQOL ) and treatment satisfaction , and to perform a cost analysis in type 1 diabetes . RESEARCH DESIGN AND METHODS We used an open-label , prospect i ve , crossover , r and omized , 16-month study ( N = 24 ) .  HRQOL and patient satisfaction were assessed with question naires ( the 36-item short-form health survey [ SF-36 ] , the World Health Organization-Five Well-Being Index [ WHO-5 ] , and the Diabetes Treatment Satisfaction Question naire [ DTSQ ] ) . Direct costs  of CIPII and continuous subcutaneous insulin infusion ( CSII ) were compared . RESULTS Question naire scores were higher with CIPII than with subcutaneous therapy . Yearly direct pump- and procedure-associated costs  for CIPII were estimated at € 10,910 compared with € 4,810 for CSII . CONCLUSIONS Apart from improving glycemic control , CIPII improved HRQOL and treatment satisfaction compared with subcutaneous insulin . Direct pump- and procedure-associated costs are considerably higher for CIPII , however BACKGROUND In a European trial in 8 countries , the subjective well-being of patients on alternative forms of treatment for insulin-dependent diabetes was compared using the 28-item WHO Well-Being Question naire , covering four dimensions of depression , anxiety , energy and positive well-being . The objective of the analysis reported here has been to identify the items of the WHO question naire which belong to an overall index of negative and positive well-being . METHODS Adult patients at 10 study centres in 8 countries who had been on insulin for at least 2 years were invited to participate in a r and omised , cross-over trial to compare insulin pump treatment with injection therapy . At each phase , patients completed questions on well-being and general health . Internal validity of the well-being index was evaluated by Cronbach 's alpha and Loevinger 's and Mokken 's homogeneity coefficients , as well as factor analysis . External validity was evaluated by comparisons with results of the general assessment questions and by the ability to discriminate between the alternative forms of treatment . RESULTS 358 patients had sufficient data for analysis . Ten items were found to constitute a valid index of well-being with respect to internal and external validity . Coefficients of homogeneity were acceptable and there was evidence for both concurrent and discriminant validity . CONCLUSIONS The WHO ( Ten ) well-being index includes negative and positive aspects of well-being in a single uni-dimensional scale . Its advantage lies in its ability to show overall change along the continuum of well-being , thus facilitating comparisons between patient groups and treatments . It is not specific to diabetes , and therefore may be useful as a disease-independent index of well-being in a broad range of health care studies AIMS Because of the high patient load in Thail and , we need a practical measurement to help primary physicians detect depression . This study aim ed to examine the reliability and validity of the Thai version of the World Health Organization-Five Well-Being Index  ( WHO-5-T ) , which is short and easy to use as a screening tool for major depression in primary care patients . METHODS The English version of the WHO-Five Well-Being Index was translated into Thai . Back-translations , cross-cultural adaptation and field testing of the pre-final version with final adjustments were performed accordingly . The WHO-5-T was administered r and omly to 300 patients in our primary care clinic . Then the patients were further assessed using the  Mini International Neuropsychiatric Interview  and the  Hamilton Rating Scale for Depression  as the gold st and ard of diagnosis and symptom severity , respectively . RESULTS Completed data were obtained from 274 respondents . Their mean age was 44.6 years [ st and ard deviation ( SD ) = 14.7 ] and 73.7 % of them were female . The mean WHO-5-T score was 14.32 ( SD = 5.26 ) . The WHO-5-T had a satisfactory internal consistency ( Cronbach 's alpha = 0.87 ) and showed moderate convergent validity with the Hamilton Rating Scale for Depression ( r = -0.54 ; P < 0.001 ) . The optimal cut-off score of the WHO-5-T < 12 revealed a sensitivity of 0.89 and a specificity of 0.71 in detecting depression . The area under the curve in this study was 0.86 ( SD = 0.03 , 95 % confidence interval 0.81 to 0.89 ) . CONCLUSIONS The Thai version of the WHO-Five Well-Being Index was found to be a reliable and valid self- assessment to screen for major depression in primary care setting at a cut-off point of < 12 AIMS To estimate harmful alcohol habits in a sample of incident sick-listed individuals compared with a r and om sample from the general population taking social background , health and work-related factors into account . METHODS Data for this cross-sectional question naire study were collected in 2008 in the Västra Götal and region , Sweden . The study population ( 19 - 64 year olds ) consisted of 2888 consecutive incident sick-leave sample ( ISS ) and 3567 individuals from a r and om population sample ( RPS ) . The mailed question naire included Alcohol Use Disorder Identification Test and vali date d instruments on health and work-related factors . Socio-demographic data came from register data . Analyses were made with χ(2 ) tests and logistic regression analyses . RESULTS No differences in prevalence of harmful alcohol habits were found between men in the ISS ( 22 % ) and the RPS ( 21 % ) . Compared with women in the ISS , a higher proportion of women in the RPS were likely to report harmful alcohol habits [ 14 versus 9 % ( P < 0.001 ) ] . This difference was confirmed in the logistic regression analyses where women in the RPS had higher odds of having harmful alcohol habits compared with women in the ISS [ odds ratio ( OR ) = 1.54 ( 95 % confidence interval ( CI ) : 1.23 - 1.89 ) ] . Even after controlling for significant confounders ( age , low income , high self-reported health and high level of perceived symptoms ) , we found that the differences in harmful alcohol habits remained [ OR = 1.44 ( 95 % CI : 1.16 - 1.81 ) ] . CONCLUSIONS Harmful alcohol habits were no commoner in men and women who belonged to the sample of incident sick-leave cases . Future studies are needed to analyse the predictive value of harmful alcohol habits on sickness absence length and the time until return to work after sickness absence Background : The point prevalence of depressive disorders in the elderly population in India varies from 13 to 25 % . Since the World Health Organization ( five ) Well-being Index ( 1998 version ) is simple and easy to administer , an attempt is made to evaluate the Indian version of this instrument to identify depression in the elderly Indian community . Objectives : ( 1 ) To determine the prevalence of depression among the elderly population of rural areas of Udupi district , Karnataka , India . ( 2 ) To determine the validity and reliability of WHO ( five ) Well-being Index ( 1998 version ) as a screening instrument to identify depressive disorders in elderly population in this Indian setting . Material s and Methods : This cross-sectional study was conducted over a period of eight months ( from March 1 to October 31 , 2002 ) in the three taluks of Udupi , Kundapura , and Karkala ; belonging to the Udupi district of South India . We selected 627 people in the age group of 60 years and above for the study . Simple r and om sampling , without replacement method , using the probability proportionate to size ( PPS ) technique was used . The WHO ( five ) well-being index ( 1998 version ) was vali date d against the major International Classification of Diseases and Related Health Problems 10th Revision ( ICD-10 ) depression inventory of mastering depression in primary care version 2.2 . Proportions and their 95 % confidence intervals were calculated and Kappa statistics was applied to determine the reliability of the screening instrument . P value<0.05 was considered statistically significant . Results : The prevalence of depression in elderly population was determined to be 21.7 % ( 95 % CI = 18.4 - 24.9 ) . The Indian version of WHO-five well-being index ( 1998 version ) showed a sensitivity of 97.0 % , specificity of 86.4 % , positive predictive value of 66.3 % and an overall accuracy of 0.89 . The Kappa statistics showed significantly high reliability of k = 0.71 . Conclusion : The Indian version of " WHO ( five ) Well-being Index ( 1998 version ) " was found to be an effective instrument for identifying depression in elderly Indian community BACKGROUND AND PURPOSE Evidence is mounting linking cerebrovascular disease with depressive symptoms in the elderly . Lesions in both white and gray matter have been associated with depressive symptoms and major depression . We sought to investigate the relationship between depressive symptoms and white and gray matter lesions in subjects participating in the Cardiovascular Health Study . METHODS In a sample of 3660 men and women who underwent a st and ardized interview , physical examination , and MRI scan  , we examined the association between number of white and gray matter lesions and white matter grade ( a measure of severity ) and reported depressive symptoms using a modified version of the Centers for Epidemiologic Studies Depression ( CES-D ) scale . We controlled for a variety of demographic and medical variables as well as functional status and Modified Mini-Mental State Examination score . RESULTS The number of small ( <3 mm ) basal ganglia lesions was significantly associated with reported depressive symptoms , but white matter grade was not . In subsequent logistic regression models , number of basal ganglia lesions remained a significant predictor after controlling for non-MRI variables and severity of white matter lesions . CONCLUSIONS Our findings extend previous reports that linked cerebrovascular changes to depressive symptoms in clinical population s to a large community-based population . This report provides further evidence of the importance of basal ganglia lesions in geriatric depression Background In the context of the DAWN-2 initiatives , the BENCH-D Study aims to test a model of regional benchmarking to improve not only the quality of diabetes care , but also patient-centred outcomes . Methods / Design As part of the AMD-Annals quality improvement program , 32 diabetes clinics in 4 Italian regions extracted clinical data from electronic data bases for measuring process and outcome quality indicators . A r and om sample of patients with type 2 diabetes filled in a question naire including vali date d instruments to assess patient-centred indicators : SF-12 Health Survey , WHO-5 Well-Being Index , Diabetes Empowerment Scale , Problem Areas in Diabetes , Health Care Climate Question naire , Patients Assessment of Chronic Illness Care , Barriers to Medications , Patient Support , Diabetes Self-care Activities , and Global Satisfaction for Diabetes Treatment . Data were discussed with participants in regional meetings . Main problems , obstacles and solutions were identified through a st and ardized process , and a regional m and ate was produced to drive the priority actions . Overall , clinical indicators on 78,854 patients have been measured ; additionally , 2,390 patients filled-in the question naire . The regional m and ates were officially launched in March 2012 . Clinical and patient-centred indicators will be evaluated again after 18 months . A final assessment of clinical indicators will take place after 30 months . Discussion In the context of the BENCH-D study , a set of instruments has been vali date d to measure patient well-being and satisfaction with the care . In the four regional meetings , different priorities were identified , reflecting different organizational re sources of the different areas . In all the regions , a major challenge was represented by the need of skills and instruments to address psychosocial issues of people with diabetes . The BENCH-D study allows a field testing of benchmarking activities focused on clinical and patient-centred indicators Background . As distress in society increases , including work environments , individual capacities to compete with stress have to be strengthened . Objective . We examined the impact of a web-based happiness training on psychological and physiological parameters , by self-report and objective means , in an occupational health setting . Methods . R and omized controlled trial with 147 employees . Participants were divided into intervention ( happiness training ) and control groups ( waiting list ) . The intervention consisted of a seven-week online training . Question naires were administered before , after , and four weeks after training . The following scales were included : VAS ( happiness and satisfaction ) , WHO-5 Well-being Index , Stress Warning Signals , Freiburg Mindfulness Inventory , Recovery Experience Question naire , and Flourishing Scale . Subgroup sample s for saliva cortisol and alpha-amylase determinations were taken , indicating stress , and Attention Network Testing for effects on attention regulation . Results . Happiness ( P = 0.000 ; d = 0.93 ) , satisfaction ( P = 0.000 ; d = 1.17 ) , and quality of life ( P = 0.000 ; d = 1.06 ) improved ; perceived stress was reduced ( P = 0.003 ; d = 0.64 ) ; mindfulness ( P = 0.006 ; d = 0.62 ) , flourishing ( P = 0.002 ; d = 0.63 ) , and recovery experience ( P = 0.030 ; d = 0.42 ) also increased significantly . No significant differences in the Attention Network Tests and saliva results occurred ( intergroup ) , except for one saliva value . Conclusions . The web-based training can be a useful tool for stabilizing health/psychological well-being and work/life balance Background Whereas the majority of previous research on social capital and health has been on residential neighborhoods and communities , the evidence remains sparse on workplace social capital . To address this gap in the literature , we examined the association between  workplace social capital  and health status among Chinese employees in a large , multi-level , cross-sectional study . Methods By employing a two-stage stratified r and om sampling procedure , 2,796 employees were identified from 35 workplaces in Shanghai during March to November 2012 .  Workplace social capital was assessed using a vali date d and psychometrically tested eight-item measure , and the Chinese language version of the WHO-Five Well-Being Index ( WHO-5 ) was used to assess mental health . Control variables included sex , age , marital status , education level , occupation status , smoking status , physical activity , and job stress . Multilevel logistic regression analysis was conducted to explore whether individual- and workplace-level social capital was associated with mental health status . Results In total , 34.9 % of workers reported poor mental health ( WHO-5<13 ) . After controlling for individual-level socio-demographic and lifestyle variables , compared to workers with the highest quartile of personal social capital , workers with the third , second , and lowest quartiles exhibited 1.39 to 3.54 times greater odds of poor mental health , 1.39 ( 95 % CI : 1.10–1.75 ) , 1.85 ( 95 % CI : 1.38–2.46 ) and 3.54 ( 95 % CI : 2.73–4.59 ) , respectively . Corresponding odds ratios for workplace-level social capital were 0.95 ( 95 % CI : 0.61–1.49 ) , 1.14 ( 95 % CI : 0.72–1.81 ) and 1.63 ( 95 % CI : 1.05–2.53 ) for the third , second , and lowest quartiles , respectively . Conclusions  Higher workplace social  capital is associated with lower odds of poor mental health among Chinese employees . Promoting social capital at the workplace may contribute to enhancing employees ’ mental health in China Wound pain is a serious problem for elderly patients suffering from chronic leg ulcers , and it may lead to reduced wound healing rates and reduced quality of life . Biatain-Ibu Non-adhesive ( Coloplast A/S ) , a new pain-reducing moist wound healing dressing containing ibuprofen was tested for pain reduction , safety , and efficacy on 10 + 2 patients in a single-blinded crossover study against Biatain Non-adhesive ( Coloplast A/S ) .  Pain was measured with a Numeric Box Scale before , during , and after dressing change . Quality of life was measured using the World Health Organization-5 Well-Being Index . Dressing moist wound healing properties such as absorption capacity and leakage were tested together with assessment of wound exu date and blood plasma content of ibuprofen . Use of the Biatain-Ibu foam dressing correlated with a decrease in pain intensity scores from 7 in the run-in period to approximately 2.5 in the Biatain-Ibu treatment phase . Quality of life measures were improved which together with the reduced pain could contribute to faster wound healing . The moist wound healing properties of Biatain-Ibu were similar to that of the Biatain Non-adhesive and ulcer size was reduced by 24 % during the treatment period . Neither side effects nor systemic plasma concentrations of ibuprofen were observed . These data indicate that Biatain-Ibu could reduce persistent and temporary wound pain , increase Quality of life , was found safe to use , and had excellent moist wound healing properties Objective : To assess the efficacy of a selective serotonin reuptake inhibitor ( paroxetine ) for relief of tinnitus . Design : One hundred twenty tinnitus sufferers participated in a r and omized double-blind placebo-controlled trial . Paroxetine or placebo was increased to a maximally tolerated dose ( up to 50 mg/day ) , and patients were treated for a total of 31 days at the maximal dose . Methods : Patients with chronic tinnitus were recruited from our university-based specialty clinic by referral from otolaryngologists and audiologists in the local community and by advertisement . Patients with psychotic or substance use disorders or suicidal ideation were excluded , as were those using psychoactive medications  ( this result ed in only 1 subject with major depression in the study ) or any other medications that interact with paroxetine and those with inability to hear at one ’s tinnitus sensation level . Fifty-eight percent of patients were male , 92 % were Caucasian , and the average age was 57 . Outcomes Measures : Tinnitus matching , the Tinnitus H and icap Question naire , the question : How severe ( bothered , aggravating ) is your tinnitus ? Quality of Well-Being and other psychological question naires . Results : Paroxetine was not statistically superior to placebo on the following tinnitus measures ( tinnitus matching , 5- or 10-db drop , Tinnitus H and icap Question naire , quality of well-being measures , how severe , how bothered , positive change ) . There was a significant improvement in the single item question , How aggravating is your tinnitus ? for those in the paroxetine group compared with the placebo group . Conclusions : These results suggest that the majority of individuals in this study did not benefit from paroxetine in a consistent fashion . Further work remains to be done to determine if subgroups of patients ( e.g. , those who tolerate higher doses , those who are depressed ) may benefit . UCSD = University of California , San Diego ABSTRACT Objective : Melatonin , the hormone produced nocturnally by the pineal gl and , serves as a circadian time cue and sleep-anticipating signal in humans . With age , melatonin production declines and the prevalence of sleep disorders , particularly insomnia , increases . The efficacy and safety of a prolonged release melatonin formulation ( PR-melatonin ; Circadin * 2 mg ) were examined in insomnia patients aged 55 years and older . Design : R and omised , double blind , placebo-controlled . Setting : Primary care . Methodology : From 1248 patients pre-screened and 523 attending visit 1 , 354 males and females aged 55–80 years were admitted to the study , 177 to active medication and 177 to placebo .  The study was conducted by primary care physicians in the West of Scotl and and consisted of a 2‐week , single blind , placebo run-in period followed by a 3‐week double blind treatment period with PR-melatonin or placebo , one tablet per day at 2 hours before bedtime . Main outcome measures : Responder rate ( concomitant improvement in sleep quality and morning alertness on Leeds Sleep Evaluation Question naire [ LSEQ ] ) , other LSEQ assessment s , Pittsburgh Sleep Quality Index ( PSQI ) global score , other PSQI assessment s , Quality of Night and Quality of Day derived from a diary , Clinical Global Improvement scale ( CGI ) score and quality of life ( WHO‐5 well being index ) . Results : Of the 354 patients entering the active phase of the study , 20 failed to complete visit 3 ( eight PR-melatonin ; 12 Placebo ) . The principal reasons for drop-out were patient decision and lost to follow-up . Significant differences in favour of PR-melatonin vs. placebo treatment were found in concomitant and clinical ly relevant improvements in quality of sleep and morning alertness , demonstrated by responder analysis ( 26 % vs. 15 % ; p = 0.014 ) as well as on each of these parameters separately . A significant and clinical ly relevant shortening of sleep latency to the same extent as most frequently used sleep medications was also found ( –24.3 vs.–12.9 minutes ; p = 0.028 ) . Quality of life also improved significantly ( p = 0.034 ) . Conclusions : PR-melatonin results in significant and clinical ly meaningful improvements in sleep quality , morning alertness , sleep onset latency and quality of life in primary insomnia patients aged 55 years and over . Trial registration : The trial was conducted prior to registration being introduced AIMS To investigate whether , in the treatment with chlordiazepoxide for outpatient alcohol withdrawal , there are advantages of symptom-triggered self-medication over a fixed-schedule regimen . METHODS A r and omized controlled trial in outpatient clinics for people suffering from alcohol dependence ( AD ) and alcohol-related problems ; 165 adult patients in an outpatient setting in a specialized alcohol treatment unit were r and omized 1:1 to either a symptom-triggered self-medication or tapered dose , using chlordiazepoxide .  Alcohol withdrawal symptoms , amount of medication , duration of symptoms , time to relapse and patient satisfaction were measured . Patients assessed their symptoms using the  Short Alcohol Withdrawal Scale ( SAWS ) . Patient satisfaction was monitored by the Diabetes Treatment Satisfaction Question naire . We used the Well-Being Index and the European addiction severity index for the 1-year follow-up . RESULTS We found no differences in the quantity of medication consumed , time to relapse , well being or treatment satisfaction . CONCLUSION Symptom-triggered self-medication was as safe as fixed-schedule medication in treating out patients with AD and mild to moderate symptoms of AWS . The SAWS is a powerful monitoring tool , because it is brief and permits the subject to log the withdrawal symptoms OBJECTIVE The onset of action of antidepressants often takes 4 to 6 weeks . The antidepressant effect of wake therapy ( sleep deprivation ) comes within hours but carries a risk of relapse . The objective of this study was to investigate whether a new chronotherapeutic intervention combining wake therapy with bright light therapy and sleep time stabilization could induce a rapid and sustained augmentation of response and remission in major depressive disorder . METHOD 75 adult patients with DSM-IV major depressive disorder , recruited from psychiatric wards , psychiatric specialist practice s , or general medical practice s between September 2005 and August 2008 , were r and omly assigned to a 9-week chronotherapeutic intervention using wake therapy , bright light therapy , and sleep time stabilization ( n = 37 ) or a 9-week intervention using daily exercise ( n = 38 ) . Patients were evaluated at a psychiatric research unit . The study period had a 1-week run-in phase in which all patients began treatment with duloxetine . This phase was followed by a 1-week intervention phase in which patients in the wake therapy group did 3 wake therapies in combination with daily morning light therapy and sleep time stabilization and patients in the exercise group began daily exercise . This phase was followed by a 7-week continuation phase with daily light therapy and sleep time stabilization or daily exercise . The 17-item Hamilton Depression Rating Scale was the primary outcome measure , and the assessors were blinded to patients ' treatment allocation . RESULTS Both groups responded well to treatment . Patients in the wake therapy group did , however , have immediate and clinical ly significantly better response and remission compared to the exercise group . Thus , immediately after the intervention phase ( week 2 ) , response was obtained in 41.4 % of wake therapy patients versus 12.8 % of exercise patients ( odds ratio [ OR ] = 4.8 ; 95 % CI , 1.7 - 13.4 ; P = .003 ) , and remission was obtained in 23.9 % of wake therapy patients versus 5.4 % of exercise patients ( OR = 5.5 ; 95 % CI , 1.7 - 17.8 ; P = .004 ) . These superior response and remission rates obtained by the wake therapy patients were sustained for the whole study period . At week 9 , response was obtained in 71.4 % of wake therapy patients versus 47.3 % of exercise patients ( OR = 2.8 ; 95 % CI , 1.1 - 7.3 ; P = .04 ) , and remission was obtained in 45.6 % of wake therapy patients and 23.1 % of exercise patients ( OR = 2.8 ; 95 % CI , 1.1 - 7.3 , P = .04 ) . All treatment elements were well tolerated . CONCLUSIONS Patients treated with wake therapy in combination with bright light therapy and sleep time stabilization had an augmented and sustained antidepressant response and remission compared to patients treated with exercise , who also had a clinical ly relevant antidepressant response . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT00149110 PURPOSE To assess the effectiveness of mindfulness-based stress reduction ( MBSR ) for mood , breast- and endocrine-specific quality of life , and well-being after hospital treatment in women with stage 0 to III breast cancer . PATIENTS AND METHODS A r and omized , wait-listed , controlled trial was carried out in 229 women after surgery , chemotherapy , and radiotherapy for breast cancer . Patients were r and omly assigned to the 8-week MBSR program or st and ard care .  Profile of Mood States ( POMS ; primary outcome ) , Functional Assessment of Cancer Therapy-Breast ( FACT-B ) , Functional Assessment of Cancer Therapy-Endocrine Symptoms ( FACT-ES ) scales and the WHO five-item well-being question naire ( WHO-5 ) evaluated mood , quality of life , and well-being at weeks 0 , 8 , and 12 . For each outcome measure , a repeated- measures analysis of variance model , which incorporated week 0 measurements as a covariate , was used to compare treatment groups at 8 and 12 weeks . RESULTS There were statistically significant improvements in outcome in the experimental group compared with control group at both 8 and 12 weeks ( except as indicated ) for POMS total mood disturbance ( and its subscales of anxiety , depression [ 8 weeks only ] , anger [ 12 weeks only ] , vigor , fatigue , and confusion [ 8 weeks only ] ) , FACT-B , FACT-ES , ( and Functional Assessment of Cancer Therapy subscales of physical , social [ 8 weeks only ] , emotional , and functional well-being ) , and WHO-5 . CONCLUSION MSBR improved mood , breast- and endocrine-related quality of life , and well-being more effectively than st and ard care in women with stage 0 to III breast cancer , and these results persisted at three months . To our knowledge , this study provided novel evidence that MBSR can help alleviate long-term emotional and physical adverse effects of medical treatments , including endocrine treatments . MBSR is recommended to support survivors of breast cancer Recent studies emphasize the negative impact of comorbidity on the course of depression . If undiagnosed , depression and comorbidity contribute to high medical utilization . We aim ed to assess ( 1 ) prevalences of depression alone and with comorbidity ( anxiety/somatoform disorders ) in primary care , ( 2 ) coexistence of anxiety/somatoform disorders in depressive patients , and ( 3 ) diagnostic validity of two screeners regarding depression with versus without comorbidity . We examined 394 primary care out patients using the Composite International Diagnostic Interview ( CIDI ) , the  General Health Question naire (  GHQ-12  ) , and the Well-Being Index ( WHO-5  ) . We conducted configurational frequency analyses to identify nonr and om configurations of the disorders and receiver operating characteristic (ROC)-analyses to assess diagnostic validity of the screeners . Point prevalence of any depressive disorder was 22.8 % ; with at least one comorbid disorder , 15 % ; and with two comorbid conditions , 6.1 % , which significantly exceeded expected percentage ( 0.9 % , P < or = .0001 ) . Depression without comorbidity occurred significantly less often than expected by chance ( P < or = .0007 ) . Comorbidity of depressive and anxiety or somatoform disorders was associated with a high odds ratio ( 6.25 ) . The screeners were comparable regarding their diagnostic validity for depression with [ GHQ-12 : area under the curve (AUC)=0.86 ; WHO-5 : AUC=0.88 ] and without comorbidity ( GHQ-12 : AUC=0.84 ; WHO-5 : AUC=0.86 ) . It can be concluded that comorbidity between depression and anxiety/somatoform disorders in primary care may occur much more frequently than expected . These results confirm assumptions that the current division between depression and anxiety might be debatable . Validity of screeners tested in our study was not affected by comorbid conditions ( e.g. , anxiety or somatoform disorders )
target: The review demonstrated that the WHO-5 has high clinimetric validity , can be used as an outcome measure balancing the wanted and unwanted effects of treatments , is a sensitive and specific screening tool for depression and its applicability across study fields is very high .
  Conclusions : The WHO-5 is a short question naire consisting of 5 simple and non-invasive questions , which tap into the subjective well-being of the respondents .
  The scale has adequate validity both as a screening tool for depression and as an outcome measure in clinical trials and has been applied successfully across a wide range of study fields
background: Background : The 5-item World Health Organization Well-Being Index ( WHO-5 ) is among the most widely used question naires assessing subjective psychological well-being .
  Since its first publication in 1998 , the WHO-5 has been translated into more than 30 language s and has been used in research studies all over the world .
  We now provide a systematic review of the literature on the WHO-5 .