Happiness and health in psychiatry; what are their implications?
Happiness is the main objective of human existence (1). According to many authorities including Greek philosopher Aristotle, all human behavior aims to achieve happiness (2,3). However, Seneca pointed out that reaching happiness is a challenging task, since it is difficult to find what makes life happy; and, many times, the more happiness is searched for, more elusive it becomes (4). In this sense, Socrates explained to Fedro that reflection about the truth would nourish the soul; whereas philosophy would be the adequate tool to achieve this goal (5).
Happiness was first investigated as an object of philosophical study. Only in the middle of the last century some empirical studies within the health and associated fields of knowledge started to appear (6,7). For this reason, the World Health Organization (WHO) has included and emphasized happiness as an important factor within the concept of health (1,8,9). Most studies on happiness are in the field of psychology (10) and economics (10,11). In psychology, for example, the concept of positive psychology has emerged (12,13); according to Seligman (2011), this is an area that studies what is right in humans as their positive attributes, that is, their active psychological characteristics and strengths. Positive psychology advocates that promoting mental health involves the promotion of psychological resources, improving the quality of life and preventing mental disorders, especially those disorders that have a strong environmental burden, thereby promoting happiness. Thus, the contributions of positive psychology can and should be considered by psychiatric clinicians and those in general medicine (15,16).
In this context, happiness can be defined as a fundamental emotion characterized as a lasting state which is combined with: (i) the absence of negative emotions; (ii) the presence of positive emotions; (iii) life satisfaction; (iv) social engagement and (v) objectives in life (8,17-19). Another concept that has been largely used for defining happiness within the specialized literature is subjective well-being (6,8,13,19). It is relevant to mention that the concept of quality of life is a broader terminology, also involving happiness itself (19).
In order to use a holistic approach to promote health (i.e., taking into account all factors that influence health), it is important to understand how a healthy person behaves and how positive emotions can contribute to this process. In this sense, as proposed by Seligman (2011), treatment is not just fixing what is broken; rather, it involves nurturing what is best within ourselves (19). Undoubtedly, the actual psychiatric medical model that mainly focuses on the diagnosis and treatment of mental disorders, has been immensely helpful to many patients; nevertheless, it is believed that it is necessary to move forwards, and this will bring benefits to all, including those with a psychiatric diagnosis (15).
Based on this, the main goal of this paper is to conduct a critical literature review concerning happiness and health which may be useful for the expansion of psychiatric practice, and also to update the article published in 2007 in the Revista de Psiquiatria Clinica titled "Happiness: a review" (18).
Computer searches were carried out within the PubMed data basis, using the keywords "happiness" and "health", during August, 2014; and in the SciELO data basis with the same keywords during November, 2014. Filters were applied, requiring that the keywords appeared in the title or abstract and that the articles had been published between September 2004 and February 2014. From the PubMed, initially 80 papers were related to this topic. After a preliminary analysis, ten papers were excluded from this sample because of the following reasons: (i) four did not cite the word happiness either in their titles or in their abstracts; (ii) two concerned topics only related to, but did not directly concern, happiness and health; (iii) four were informative articles (Figure 1). Regarding the SciELO data basis, 47 papers were found; however, only six contained the word happiness in their titles and/or abstracts.
In addition to these searches, another was performed using the reference lists of the papers already selected. This was rewarding in allowing us to identify the classic work provided by significant authors in this field, such as Martin Seligman, Robert Clonniger anda Ruut Veenhoven, as well as the importance in this context of the WHO (Table 1).
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Based on the results from these searches, it was possible to identify six core aspects related to the keywords "happiness" and "health", namely:
1. Aspects of happiness;
2. Biology of happiness;
3. Psychology of happiness;
4. Sociodemography of happiness;
5. Health, mental health and happiness;
6. Positive implications for psychiatry.
Each of these aspects is described further in the following section.
Aspects of happiness
The scientific literature often refers to two types of happiness: psychological well-being and hedonic well-being. The term psychological well-being, or eudaimonia, has been used to refer to a combination of character strengths involving self-direction (e.g., autonomy, purpose of life, environmental and self-acceptance), cooperatives (i.e., positive relationships with others) and self-transcendence (i.e., personal growth and self-realization) (8,12). Hedonic well-being, or hedonia, is associated with: (i) a pleasurable life; (ii) life satisfaction; (iii) presence of positive feelings and (iv) absence of negative feelings (20). It can be said, therefore, that psychological well-being is connected to the personal fulfillment of one's own potential, while hedonic well-being is linked to the experience of satisfaction.
Although these are two different ways to experience happiness, they are strongly related (8,12,20). However, from a historical point of view, they have different origins. Aristotle postulated that every human being had unique capabilities, called daimon, that should be recognized and developed (3). Similar to this idea are the concepts/ theories of: (i) self-actualization, described by Maslow; (ii) the individualization theory developed by Jung; and (iii) Antonovsky's theory of existential coherence; all are related to the concept of eudaimonia (20,21). It is relevant to note that Epicurus provided the basis for the later development of hedonism. (20) The biological differences between each type are discussed further below.
Besides these two types of happiness, it is important to distinguish two types of emotions or affects that are connected to the understanding of happiness: positive affect and negative affect. These are independent variables and may or may not be in opposition (18); it is possible to feel positive and negative emotions at the same time, as well as being in a neutral state. These emotions/affects might seem to have different determinants, consequences and correlations (14), and it is relevant to note that happiness itself is related to the frequency of positive emotions and not to their intensity (14,18). Negative emotions, such as fear and anger, are recognizably beneficial as they help people to ensure their survival and safety. Nevertheless, these are short-term benefits; the Broaden and Build Theory states that positive emotions amplify cognition and behavior, providing intellectual, social and physical resources for optimum performance. Thus, the long term benefits of positive emotions contribute to the individual's ability to continue his/her development (14).
Biology of happiness
Trying to understand the complex link between psychological factors and biological change, scientists have studied the effects on health of negative emotions. For example, it is known that stress, depression and anxiety generate changes in the hypothalamic-pituitary-adrenal axis, with a consequent increase of cortisol, sympathetic stimulation and elevation of proinflammatory markers. If these negative stimuli persist, the risk increases of developing cardiovascular disease, cancer and/or infections (22,23). However, only recently has scientific interest focused on verifying that positive emotions could also induce biological changes. Some studies have demonstrated that the two types of happiness (eudaimonia and hedonia) can cause biological changes that promote positive emotions (24); however, most of this research has shown that only eudaimonia is statistically related to biological changes (12,20,22). In general, the changes found in the neuroendocrine, immune and cardiovascular systems secondary to positive emotions are beneficial and protective effect (12,23).
First, positive emotions can quickly cancel the adverse effects of body stress reaction, and thus return the body to a steady state (14). It may be interesting to see how this biological characteristic of positive emotions corresponds to the observation that many people say they feel good, even through times of suffering, if adverse events are interpreted as having a purpose or meaning (8). Perhaps this search for meaning is a psychic attempt to maintain an emotional balance.
Second, higher levels of eudaimonia are related to lower levels of salivary cortisol and proinflammatory cytokines, a lower cardiovascular disease risk, longer duration of REM sleep (20,23), higher levels of immunoglobulin A, and higher HDL cholesterol levels (12) compared to those with low levels of eudaimonia. There are, however, differences between men and women in this regard; for example, inflammatory markers such as C-reactive protein and fibrinogen are lower in happy women than in happy men (24).
These alterations have been found regardless of the presence of negative emotions, suggesting that happiness has a direct effect on the body, regardless of the absence of negative affect (23). On the other hand, in the same manner as tobacco and some physical leisure activities are found in stressed individuals, depression and anxiety and their associated behaviors contribute to increased rates of diseases and adverse biological changes; part of the positive biological findings in happy individuals is also due to their tendency towards healthier habits and more prudent lifestyles (23).
Another important point is that studies of monozygotic twins, separated and raised in different environments, have shown that happiness has a genetic component of 35%-50% in humans (6,14,25). In this regard, it is suggested that the long allele of the promoter region of the 5-HTT gene (5-HTTLPR long) could be associated with optimism. The 5-HTT gene encodes serotonin transporters; this type of polymorphism in the promoter region is called a functional polymorphism (26). De Neve found that individuals satisfied or very satisfied with life have a statistically significant higher percentage of this genotype (long 5-HTTLPR homozygous), compared to people dissatisfied with life. Recently, it was discovered that, in women, a low MAO gene expression is significantly associated with increased levels of happiness. This finding, however, was not present in men (26).
It is important to consider that many of these studies have some limitations such as small sample sizes, cross-sectional designs or bivariate analyses. Still, the studies are promising and already point us in several directions.
Psychology of happiness
If 35%-50% of happiness depends on a genetic influence, at least 30%-40% are represented other variables, suggesting that the environment and life events also have a large influence on subjective well-being. However, this influence varies from event to event; personal interpretations may be the key to understanding the link between life events and subjective well-being (6). In this sense, character has a strong impact on the perception of all aspects of health, including physical, social and emotional well-being. For example, self-direction is measured by levels of responsibility, ingenuity and ability to find meaning, and has a strong connection with all aspects of health. Changes in self-direction explain about 32% of the variations in the risk of disease and about 45% of the variations in subjective well-being.
The way in which an individual sees life can predict his/her health outcomes. For example, pessimists need to visit four times as many doctors in one year than optimists (17). Similarly, the link between success and happiness exists not only because success makes people happy, but because positive attitudes engender success (27). A concept that may explain these relationships is emotional competence (EC), also known as emotional intelligence. This concept relates to how the individual deals with emotional information, intrapersonally and interpersonally. High EC is associated with greater happiness, and higher mental and physical health, greater professional success and greater satisfaction in social relationships and marriage (28).
Christakis and Fowler used the Framingham study to try to answer the following question: can the happiness of others influence personal happiness? The study was based on the theory that emotional states can be transferred interpersonally through mimicry, by copying emotionally relevant bodily actions, especially facial expressions, and it concluded positively. The authors suggested that happiness may be seen as a network phenomenon; happiness clusters resulted from the spread of happiness and not only by the tendency of people to associate with similar individuals (29). Although this theory of social contagion has also been replicated in disorders such as depression, a study involving roommates in college resulted in different findings, arguing that happiness and mental disorders have low social contagion (30). Perhaps the last word on the subject has not yet been given, but there is no doubt that this is an exciting area.
Sociodemography of happiness
Several factors associated with happiness have been studied. Below we describe some that appear in more recent studies and have not been reported in other review articles on happiness.
The first modern economist to study happiness found a paradox (i.e., the Easterlin paradox) in which groups of richer countries are happier than groups of poorer countries, but this difference is not so clear between rich and Latin American countries where there are larger social differences. Even in poor countries, the relationship between money and happiness is not linear. Deprivation and poverty are less associated with happiness (31) however, after reaching a level of care that meets basic needs, other factors, such as people's increased aspirations and concerns about their own heritage come into play (10,32). Indeed, despite the economic changes, happiness levels have remained relatively stable in countries such as Ireland and the United States (17,33); a study linking retirement and welfare showed that monetary gain increased financial well-being, but the benefits of retirement on health and subjective and social welfare were transient (34). Another binding factor between economic issues and happiness seems to be social inequality, since individuals living in areas of great social inequality tend to describe themselves as unhappy and unhealthy (35). From the individual point of view, however, people who are paid by the hour appear to be happier (36). In addition, informal workers tend to report higher levels of happiness related to their professional activity (37). Another factor that may explain this lack of linearity between economic issues and subjective well-being levels is that happy people tend to focus more on social ideals and moral goals than just monetary achievement (7).
With increasing age, happiness tends to decrease in the population as a whole (38,39). However, from the individual point of view, centenarians who have high levels of satisfaction with their lives in the past tend in their old age to make the best personal assessments of their own health, economic security and happiness (40). Therefore, there is a protective relationship between happiness and physical decline that occurs in old age (41,42). In this age group, contentment related to the children and the health of the family is associated with a higher level of happiness (43). Moreover, happiness is related to longevity, independent of family genetic and environmental issues (44). Finally, a rather curious result was obtained from a longitudinal study that found a positive association between chocolate consumption, optimism, better health and greater psychological well-being (45).
People living in minority groups tend to report less happiness than those who belong to majority groups (7). For example, after the tragic events of September 11, 2001 in the United States, Arab Americans reported a greater perception of abuse and discrimination; this perception was related to higher levels of psychological stress, worse health outcomes and a lower sense of happiness (46).
Married people tend to experience better health and happiness than unmarried people. This relationship has been found in various countries, within various health parameters and in both men and women (47). This association, however, extends beyond marital status, because the quality of marriage also has a great influence on it (47-49). There is also a positive relationship between happiness and sexual satisfaction in women and men, although that relationship is stronger in women (50).
Religiosity and volunteering
It is well established that people who identify themselves as religious tend to report better health and more happiness, regardless of their religious affiliation, performance of the religious activities, work, family, social support or financial situation (51). The studies that have reached these conclusions were mostly carried out in the western population. However, research on Islamic and Egyptian students also found a positive relationship between religious affiliation and happiness (52-54). Seen as human dimensions by many researchers, these aspects tend to be increasingly taken into consideration in the treatment and development of people (15,55), especially considering that the humans are religious beings, since they spend more time praying than having sex (15).
Another related aspect is the issue of volunteering and altruism. People who engage in volunteer work and altruistic behaviors tend to be healthier, live longer, and to be happier (56-58). However, when this type of activity becomes too arduous, occupying more than 11 hours per week, the happiness levels tend to decrease (56,58).
Educational level, sports and leisure
The positive relationship has long been recognized between education levels, intelligence quotient (IQ) and health levels. More recently, a positive relationship has also been found between educational levels, IQ and the happiness index (10,59,60).
Other factors studied in recent years include physical leisure activities that have been shown to increase subjective well being, both in the short and long term (61). Involvement in sport also appears to have a causal relationship with higher levels of happiness (62).
Finally, it is worth remembering the psychological theory of the set point of happiness, according to which people have a basal level of happiness that they tend to return to over time, even after major events such as winning the lottery or divorce. However, unemployment is one of the events that has a negative impact on happiness that people tend not to adapt to (10).
Health, mental health and happiness
Happiness and health are closely related, both on an individual and population basis; happier people and communities tend to be healthier, and the inverse relationship is also true (63). This relationship was also found in adolescents (64), the young (65,66) and the elderly (67). However, in the elderly, a study found that health predicted subjective well-being, but the reverse was not true (68), perhaps because, in this population, other factors previously listed in the sociodemography of happiness subsection (3,4) came into play. As examples, the happiest nations tend to have lower levels of blood pressure (69); a study of coronary artery disease (CAD) found that optimistic men had a lower risk of developing CAD17; and happier people recovered better from sickness (70).
It is well known that chronic diseases are associated with negative impacts on various aspects of the quality of life, including happiness, and increase the risk of depression (71). However, different chronic diseases seem to impact differently on subjective well-being (71). In the elderly, for example, the physical diseases that impose decreased happiness were disabling pain and urinary incontinence; these disturb the activities of daily living and are associated with social stigmas (67).
Furthermore, mental disorders in general, and specifically depression, alcohol and drug abuse (72) and anxiety (72,73) more negatively affect happiness than does physical illness. Similarly, there is an inverse relationship between suicide and the subjective well-being index, and also between the presence of mental disorders and happiness (74). For this reason, it has been proposed that happiness indices could be used as population markers for mental disorders (74). In this sense, the ability to exercise control over adaptive negative emotions is associated with beneficial results in mental health (75). However, excessively large or small variations in positive emotions are associated with poorer mental health, particularly depression and anxiety disorders, lower life satisfaction and more unhappiness (76). Perhaps this issue of emotional control can also explain the association between mental disorders and unhappiness, and the large presence of negative emotions that mental disorders cause.
Positive implications for psychiatry
Given all of the above, a question must be raised: is possible and is it desirable to promote happiness? The evidence appears to say yes. Happiness does not cure the disease but makes people less sick and the size of this effect appears to be comparable to smoking or not (77). In mental health, in particular, the study of factors that lead to happiness can be particularly beneficial in those at higher risk of developing mental disorders (18). In fact, positive psychological interventions have already been successfully tested in patients with depressive disorders (78). Furthermore, investment in approaches that increase subjective well-being may be cheaper for the public purse. For example, a study comparing psychotherapy versus paying monetary damages in legal compensation cases showed that psychological approaches may be up to 32 times cheaper than financial compensation, as well as being more effective in promoting health and happiness in patients potentially involved in litigation (79). The understanding of what promotes happiness in people can also be useful for mental health professionals themselves since they are at risk of decreased life satisfaction and burnout syndrome; this can have negative consequences for psychiatric patients, since high levels of stress in these professionals predict therapeutic problems in general (80).
Positive psychology contains the concept of flourish. This concept suggests five features found in happy people (PERMA) that should be promoted to increase levels of subjective well-being in people in general:
1. Positive emotions (P)
2. Engagement (E; being in the flow)
3. Relationships (R; having healthy relationships)
4. Meaning (M; purpose in life)
5. Accomplishment (A)
Investment in any of these areas promotes the others and helps develop happiness (81,82).
In addition to increasing happiness, feeding positive emotions such as gratitude, kindness, perseverance, optimism and creativity, contributes to increased resilience, buffers psychological stress and promotes mental health. Programs such as the Penn Resiliency Program (PRP), developed for this purpose, have been successfully implemented in the United States, the United Kingdom, Australia, Portugal and China. In this program, participants learn to adopt more optimistic explanatory styles, detecting inaccurate thoughts, challenging negative beliefs and considering alternative interpretations. In addition, a task force made up of several positive psychology professionals developed an inventory to help people identify their character strengths; this is called the Values in Action Inventory of Strengths (VIA-IS). Despite its limitation of being based on self-report, the simple application of this instrument has been shown to be therapeutic in itself and has brought positive results. The VIA -IS and the PRP are intended for use by adults and children. There is also a tool named Appreciative Inquiry, used in institutions, that aligns with positive psychology. By means of this instrument, groups are helped to refocus problems towards the identification of existing strengths in group members, thus providing a starting point for positive change (14).
We have critically reviewed the literature on the relationship between happiness and health in order to identify the most relevant information for psychiatry. We especially considered data that were also being studied in the latest research, and not only the findings of classical studies. Studies are numerous; nevertheless, we realize that many studies on the topic of happiness are transversal; this, despite the use of large samples, diminishes the robustness of some conclusions. In addition, the measurement scales are often limited by being of the self-report variety. In a sense, we already find this difficulty in psychiatry itself in its use of subjective medical measurements, such as pain. However, analysis of the concept of happiness and its associated emotions may be more complex than describing the symptoms ofpsychiatric disorders, which can expose us to some difficult biases that are difficult to bypass. Another limitation of some studies seems to lie in their contained psychotherapeutic interventions. Although there are well-established interventions within positive psychology (some have been reported in this article) as well an interesting proposal for psychoeducation made by Clonniger (2006), progress in the expansion of clinical approaches seems to be necessary. In addition, most therapeutic interventions proposed have comprised a more psychoeducative approach. Certainly, some of these limitations exist because the interest of the health sciences in this topic is relatively recent. Moreover, is an area that is more linked to the formulation of psychotherapeutic approaches and this tends to discourage investment in the development of new psychoactive drugs.
The study of happiness from a scientific perspective, together with a realization of its implications for health is promising and fascinating, especially if we believe our medical indices of good health are not always in agreement with the perceptions of the patient or society. For example, consider the population of Matsigenka in the Peruvian Amazon; over the past 30 years health indicators have improved greatly, but during the same time period this population reported itself as sicker and unhappier (83). Perhaps for similar reasons psychiatry has failed to increase subjective well-being in the general population, despite extensive pharmacological advances and new psychotherapeutic techniques. Probably, the focus has been almost exclusively pathological (15).
The immediate goal of all medicine is to alleviate suffering. To achieve this in psychiatry, accurate diagnostic, psychopharmacological advances and psychotherapeutic techniques are fundamental. However, identify what makes life happy can be useful in various types of health prevention (primary, secondary and tertiary) (84). This particularly applies to promoting mental health as specified in the WHO parameters: a state of well-being in which people can understand and use their own skills, deal with the stresses of life, work and love, and may contribute to their communities (8,9). Furthermore, the promotion of mental health may contribute to reducing the stigma towards psychiatry and psychiatric patients (15).
Positive emotions related to happiness generate beneficial alterations in the neuroendocrine, immune and cardiovascular systems. Aspects of character, such as self-direction, are strongly linked to higher levels of happiness. According to the Easterlin paradox, the relationship between money and happiness is not linear. Levels of happiness tend to fall with increasing age; however, the previous level of subjective well-being is a major predictor of happiness in this age group. Religious people who practice physical leisure activities, who have high educational levels or higher IQs, who are married, who are involved in sports, or do up to 11 hours of volunteer work per week tend to report higher levels of happiness. In addition, higher levels of happiness are related to lower physical and mental illness, as well better coping abilities in adversity For this reason, the study of happiness brings several positive implications for psychiatry that should be considered in clinical practice and in future research.
Received; 7/4/2015--Accepted; 4/29/2015
The corresponding author thanks Dr. Rodrigo Tavares, Ph.D., for the academic tips.
Conflicts of interest
Dr. Amaury Cantilino received lecture fees from Abbott Brazil. Dr. Hermano Tavares is a research productivity fellow from the National Council on Research (CNPq).
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LEONARDO MACHADO , HERMANO TAVARES , KATIA PETRIBU , MONICA ZILBERMAN , RENATA FERRAZ TORRES , AMAURY CANTILINO 
 Post-Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE).
 Institute of Psychiatry, Hospital of the Faculty of Medicine, University of Sao Paulo (IPq-HOFMUSP).
 Post-Graduate Program in Health Sciences, Faculty of Medical Sciences, University of Pernambuco (UPE).
 Analytical Psychology Society of Sao Paulo.
Address correspondence to: Leonardo Machado. Rua Francisco da Cunha, 796, sala 9, Boa Viagem--51020-041--Recife, PE, Brazil. E-mail: leomachadoT@gmail.com
Table 1. Papers from 2013 to 2014 selected for this review Author Title Year Ali A, Ambler G, The relationship 2013 Strydom A, Rai D, between happiness Cooper C, McManus S, and intelligent et al. quotient; the contribution of socioeconomic and clinical factors Baruch Y, Swartz M, Staff happiness and 2013 Sirkis S, Mirecki I, work satisfaction in Barak Y a tertiary psychiatric centre Binder M, Coad A "I'm afraid I have 2013 bad news for you ..." Estimating the impact of different health impairments on subjective well- being Brasseur S, Gregoire The Profile of 2013 J, Bourdu R, Emotional Competence Mikolajczak M (PEC): development and validation of a selfreported measure that fits dimensions of emotional competence theory Chen H, Pine DS, The MAOA gene 2013 Ernst M, Gorodetsky predicts happiness E, Kasen S, Gordon in women K, et al. Christakis NA, Social contagion 2013 Fowler JH theory: examining dynamic social networks and human behavior Doherty M, Kelly BD When Irish eyes are 2013 smiling: income and happiness in Ireland, 2003-2009 Eisenberg D, Social contagion of 2013 Golberstein E, mental health: Whitlock J L, Downs evidence from MF college roommates Gana K, Bailly N, Relationship between 2013 Saada Y, Joulain M, life satisfaction Trouillet R, Herve and physical health C, Alaphilippe D in older adults: a longitudinal test of cross-lagged and simultaneous effects Gruber J, Kogan A, Happiness is best 2013 Quoldbach J, Mauss kept stable: positive IB emotion variability is associated with poorer psychological health Kang Y, Gruber J Harnessing 2013 happiness? Uncontrollable positive emotion in bipolar disorder, major depression, and healthy adults Lehmann BA, Bos AER, Ageing with an 2013 Rijken M, Cardol M, intellectual Peters GJY, Kok G, disability: the Curfs LMG impact of personal resources on well-being Mitchell L, Frank The geography of 2013 MR, Harris KD, Dodds happiness: PS, Danforth CM connecting twitter sentiment and expression, demographics, and objective characteristics of place Proulx CM, Snyder- The longitudinal 2013 Rivas LA associations between marital happiness, problems, and selfrated health Ruseski JE, Sport participation 2014 Humphreys BR, and subjective Hallman K, Wicker P, wellbeing; Breuer C instrumental variable results from German survey data Sahraian A, Gholami Association between 2013 A, Javadpour A, religiosity and Omivadir B happiness among a group of Muslim undergraduate students Tay L, Kuykendall L Promoting happiness; 2013 the malleability of individual and societal subjective wellbeing Van Campen C, de Are informal 2013 Boer AH, Iedema J caregivers less happy than noncaregivers? Happiness and the intensity of caregiving in combination with paid and voluntary work Author Sample Main findings Ali A, Ambler G, The authors analysed Those in the lowest Strydom A, Rai D, data from the 2007 IQ range (70-99) Cooper C, McManus S, Adult Psychiatric reported the lowest et al. Morbidity Survey in levels of happiness England (6870 compared with the participantes aged highest IQ group 16 years or over and (120-129) living in private households were included in the study) Baruch Y, Swartz M, 209 staff (185 Highest levels of Sirkis S, Mirecki I, nurses, 110 happiness were Barak Y administrative reported by staff, 61 psychologists and psychiatrists, 35 social workers and psychologists, 20 the lowest by social workers and nursing staff. Work 39 others) at a orientations as a large university- "job", "career" and affiliated tertiary a "calling" also care psychiatric differed between centre sectors with the highest levels of work as a "calling" reported by psychiatrists and the lowest by administrative staff Binder M, Coad A 100,265 observations The strongest from the British negative effect in Household Panel happiness is for Survey (BHPS) alcohol and drug database (1996- abuse, followed by 2006) anxiety, depression and other mental illnesses, stroke and cancer A puzzling asymmetry was detected: strong adverse reactions to deteriorations in health appear alongside weak increases in well- being after health improvements Brasseur S, Gregoire Five samples for a The authors J, Bourdu R, total of 5676 developed and Mikolajczak M subjects (4753 women validated in four and 923 men, aged 15 steps a complete to 84 years) in USA (albeit short: 50 items) self- reported measure of EC: the Profile of Emotional Competence Chen H, Pine DS, Data (The Children In women, low Ernst M, Gorodetsky in the Community- expression of MAOA E, Kasen S, Gordon CIC) for this study (MAOA-L) was related K, et al. were drawn from the significantly to 345 Caucasian greater happiness subjects include 193 after adjusting for women and 152 men the potential who were assessed effects of age, for MAOA genotype in education, household 2010 at mean age of income, marital 38 and happiness in status, employment 2004 at mean age of status, mental 33 disorder, physical health, relationship quality, religiosity, abuse history, recent negative life events and self-esteem use in linear regression models. In contrast, no such association was found in men Christakis NA, The authors describe The authors describe Fowler JH the methods we have the regularities employed (and the that led them to assumptions they propose that human have entailed) to social networks may examine several exhibit a "three datasets with degrees of complementary influence" property, strengths and and they review weaknesses, statistical including the approaches we have Framingham Heart used to characterize Study, the National interpersonal Longitudinal Study influence with of Adolescent respect to phenomena Health, and other as diverse as observational and obesity, smoking, experimental cooperation, and datasets that we and happiness others have collected Doherty M, Kelly BD Data from the There was a slight European Social decline in happiness Survey (ESS) between 2005 and relating to self- 2009, as mean self- rated happiness and rated happiness social and score changed from psychological 7.94 (2005) to 7.55 correlates of (2009). happiness in Ireland Satisfaction with in 2003 (n = 2,046), health had the 2005 (n = 2,274), strongest 2007 (n = 1,794) and association with 2009 (n = 1,764) happiness in 2003, 2005 and 2007. Satisfaction with income, relative to other variables, increased over time and in 2009 had the strongest association with happiness Eisenberg D, Data come from Findings are Golberstein E, online surveys of consistent with no Whitlock J L, Downs first-year college significant overall MF students. The contagion of mental authors conducted health and no more the surveys at two than small contagion large and effects for specific academically mental health competitive measures, with no universities: one evidence for public school with happiness contagion approximately 6000 and modest evidence first-year students for anxiety and (hereafter depression "university A"), and contagion. The one private school similarity of with approximately baseline mental 4000 first-year health predicts the students closeness of ("university B"). roommate The authors fielded relationships, which the baseline survey highlights the in August 2009, potential for shortly before selection biases in students arrived at studies of peer college, and the effects that do not follow-up survey in have a clearly March-April 2010, exogenous source of shortly before the variation end of the academic year Gana K, Bailly N, The study included Both cross-lagged Saada Y, Joulain M, 899 participants and simultaneous Trouillet R, Herve aged 64 to 97 years coefficients C, Alaphilippe D and assessed 5 times indicated that poor over an 8-year health significantly period predicted subsequent levels of life dissatisfaction, but life satisfaction did not predict subsequent levels of health Gruber J, Kogan A, Study 1 included a Greater macro- and Quoldbach J, Mauss sample of 244 adult microlevel IB participants from variability in the Denver, positive emotion was Colorado, community. associated with Study 2 consisted of worse psychological 2,391 francophone health, including adults recruited lower well-being and through a large life satisfaction online study and greater mentioned during the depression and French TV show Leurs anxiety (Study 1), Secrets du Bonheur and lower daily satisfaction, life satisfaction, and happiness (Study 2) Kang Y, Gruber J Participants Across all included adults with participants, bipolar 1 disorder reliving a (BD; n = 32), major controllable depression (MDD; n = positive emotion 32), and or experience was nonpsychiatric associated with controls (CTLs; n = exhibited increased 31) respiratory sinus arrhythmia, an autonomic marker of regulatory control. Interestingly, only the MDD group reported increased positive emotion and decreased cardiovascular arousal when reliving an event involving uncontrollable positive emotion, compared to the BD and CTL groups Lehmann BA, Bos AER, Longitudinal survey Age is positively Rijken M, Cardol M, data on 667 people related to decreased Peters GJY, Kok G, with a mild or mobility and Curfs LMG moderate auditory intellectual disabilities and disabilities (ID) negatively related were acquired via to independent interviews in 2006 living, autonomy in and 2010 how one spends one's leisure time and autonomy in decision-making. Longitudinal analyses demonstrated that, with the exception of health that deteriorated, and social satisfaction that improved, almost all variables remained stable over the 4-year period. Further, good physical health in 2006 predicted happiness in 2010 Mitchell L, Frank This article Happiness within the MR, Harris KD, Dodds combining (1) a US was found to PS, Danforth CM massive, geo-tagged correlate strongly data set comprising with wealth, showing over 80 million large positive words generated in correlation with 2011 on the social increasing house- network service hold income and Twitter and (2) strong negative annually-surveyed correlation with characteristics of increasing poverty. all 50 states and Happiness close to 400 urban anticorrelates populations significantly with obesity Proulx CM, Snyder- The sample included Unidirectional Rivas LA 707 continuously coupling existed for married adults who marital happiness participated in all and self-rated six waves of the health only, such Marital Instability that higher levels Over the Life Course of marital happiness panel study. predicted subsequent Participants elevations in self- averaged 35 years in rated health over age at the first time. No evidence wave and were was found for continuously married bidirectional to the same spouse coupling between over the 20-year marital problems and period self-rated health Ruseski JE, The sample used in Individuals who Humphreys BR, the empirical participate in sport Hallman K, Wicker P, analysis contains have higher life Breuer C 1238 adults between happiness. The the ages of 18-70 results suggest a U- who responded to the shaped relationship question about between age and happiness self-reported happiness. Higher income is associated with greater selfreported happiness, males are less happy than females, and single individuals are less happy than nonsingles Sahraian A, Gholami 271 undergraduates It was found that A, Javadpour A, medical students higher score on Omivadir B attending Shiraz religious belief was University of significantly linked Medical Sciences in to the level of Iran happiness Tay L, Kuykendall L Literature review on Research now shows subjective wellbeing that although subjective wellbeing is heritable and stable, it can change substantially over time. Long- term changes can be affected by positive or negative life events; subjective wellbeing interventions have also proved to be effective for boosting wellbeing for as long as six months. At the societal level, economic factors matter for the subjective wellbeing of citizens. Economic wealth is shown to be a predictor of societal wellbeing across countries and over time. Also, high unemployment severely lowers the wellbeing of individuals and has spillover effects on other societal members, such as the employed Van Campen C, de The sample consisted Caregivers are Boer AH, Iedema J of 336 informal happier than caregivers and 1765 noncaregivers when noncaregivers in the they provide care Dutch population for < 6 hours a week; and in line with the burden assumption, the results show that providing care for more than 11 hours a week is associated with lower levels of happiness. Other results contradicted the burden assumption that combining caregiving with paid or voluntary work is associated with more time burden and less happiness. The result that combining caregiving with paid employment or volunteering is related to higher rates of happiness confirms the subjective well- being assumption Author Main limitations Conclusion Ali A, Ambler G, The use of a single Those with lower IQ Strydom A, Rai D, question to measure are less happy than Cooper C, McManus S, happiness. It is those with higher et al. easier for people IQ. Interventions with lower IQ to that target understand compared modifiable variables with using a such as income and detailed inventory, neurotic symptoms however the may improve levels subjective nature of of happiness in the the happiness lower IQ groups measure may affect its validity and the use of a single- item question may be less valid in those with higher IQ Baruch Y, Swartz M, Less than half of Satisfaction with Sirkis S, Mirecki I, all staff life is not "driven" Barak Y participated, the by work orientation. questionnaires Psychiatrists chosen were brief perceive their work and designed for as a calling but do survey purposes not seem to benefit rather than in- from this in their depth evaluations satisfaction with life Improving staff happiness may contribute to increase in moral and counter burnout Binder M, Coad A The measure of life Bad health decreases satisfaction was individuals' made from a single happiness question. Subjective differently well-being questions were elicited via self-completion, while health condition answers by an interviewer. Bias could result if individuals systematically answer health questions differently in the interviewer's presence Brasseur S, Gregoire -- Analyses performed J, Bourdu R, on a representative Mikolajczak M sample of 5676 subjects revealed promising psychometric properties. The internal consistency of scales and subscales alike was satisfying, factorial structure was as expected, and concurrent/ discriminant validity was good Chen H, Pine DS, There is no single This new finding may Ernst M, Gorodetsky "happiness" gene and help explain the E, Kasen S, Gordon likely to be a set gender difference on K, et al. of genes whose happiness and expression provide a link influences between MAOA and subjective well- human happiness being. Future work should attempt to identify other genes that are associated with human happiness Christakis NA, -- The authors do not Fowler JH claim that this work is the final word, but they do believe that it provides some novel, informative, and stimulating evidence regarding social contagion in longitudinally followed networks. Along with other scholars, they are working to develop new methods for identifying causal effects using social network data, and they believe that this area is ripe for statistical development as current methods have known and often unavoidable limitations Doherty M, Kelly BD Absence of data Despite dramatic relating to certain changes in economic variables that have circumstances and a been associated with slight decline in happiness in happiness, the Irish previous studies. continued an This study was also historic tradition limited in its of rating ourselves ability to assess as generally very religiosity in happy people of no religion, but this is due to the limitations of the ESS Eisenberg D, Perhaps the most These results Golberstein E, important question suggest that mental Whitlock J L, Downs about the results of health contagion is MF this study is how lower, or at least they generalize to more context other social specific, than contexts. Contagion implied by the may be quite recent studies in different across the medical other social ties, literature particularly more intimate relationships such as spouses, siblings, and longtime friends. Contagion may also vary considerably by age group, considering how people's social relationships and networks evolve during their Gana K, Bailly N, Cross-lagged and These findings Saada Y, Joulain M, simultaneous contradict, at least Trouillet R, Herve structural models in this older C, Alaphilippe D provide tests of sample, the reciprocal postulates of influences between positive psychology, constructs over and support the time, not of bottom-up approach causality. The to well-being as assessment of self- well as the popular perceived health adage, "As long as with a one-item you've got your question is also health" disputed Gruber J, Kogan A, Cross-sectional Taken together, Quoldbach J, Mauss study these findings IB support the notion that positive emotion variability plays an important and incremental role in psychological health above and beyond overall levels of happiness, and that too much variability might be maladaptive Kang Y, Gruber J Emotion control was These findings self-defined by the suggest that participants in this although study, so we cannot controllable know precisely how positive emotion successful people experiences may be actually were in adaptive for most, controlling their individuals with a emotions in the history of recalled events restricted affect and depressed mood may actually derive more pleasure from times of unharnessed happiness Lehmann BA, Bos AER, Most of the items Despite the fact Rijken M, Cardol M, were dichotomous as that age is Peters GJY, Kok G, asking people with associated with Curfs LMG ID to answer poorer physical and questions is not mental health and a always easy Some smaller social associations were network, this study barely significant showed that older and had weak effect people with ID have sizes and should relatively high therefore be levels of well- interpreted with being caution Mitchell L, Frank There are a number The results show how MR, Harris KD, Dodds of legitimate social media may PS, Danforth CM concerns to be potentially be used raised about how to estimate real- well the Twitter time levels and data set can be said changes in to represent the population-scale happiness of the measures such as greater population. obesity rates Furthermore, the fact that the authors collected only around 10% of all tweets during the calendar year 2011 means that their data set is a nonuniform subsample of statements made by a nonrepresentative portion of the population Proulx CM, Snyder- Findings cannot be Similar to human Rivas LA generalized to all development married individuals, scholars' assertion a focus on people that aging who were married adults are survivors continuously across of conditions and 20 years provides events related to an evidence of the increased risk of associations between mortality, marital happiness individuals in long- and self-rated term marriages may health in long-term be considered marriages. All survivors of health and marital relationship quality variables problems and other were self-reports, challenges that and objective and could have observational contributed to measures, marital dissolution respectively, may yield different results Ruseski JE, Cross-sectional This broader impact Humphreys BR, study of sport Hallman K, Wicker P, Telephone interview participation on Breuer C general happiness lends support to the policy priority of many governments to increase sport participation at all levels of the general population Sahraian A, Gholami Cross-sectional The result confirms A, Javadpour A, study that individuals Omivadir B with a more religious attitude experience more happiness. The result of this study should be considered in programs designed to improve overall well-being of university students Tay L, Kuykendall L Is not a systematic For practitioners, review article policy makers, and economists interested in the wellbeing of individuals, this article propose that these findings have implications for mental health practice and economic policies Van Campen C, de The variables of It is concluded that Boer AH, Iedema J burden and happiness these cross- were measured with sectional results single items. Cross- open ways to sectional study longitudinal research that can inform governments in the development of policies to support informal caregivers
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|Author:||Machado, Leonardo; Tavares, Hermano; Petribu, Katia; Zilberman, Monica; Torres, Renata Ferraz; Canti|
|Publication:||Archives of Clinical Psychiatry|
|Date:||May 1, 2015|
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