Background Depression is an important public-health problem, and one of the leading causes of disease burden worldwide. Depression is often comorbid with other chronic diseases and can worsen their associated health outcomes. Few studies have explored the eff ect of depression, alone or as a comorbidity, on overall health status. Methods The WHO World Health Survey (WHS) studied adults aged 18 years and older to obtain data for health, health-related outcomes, and their determinants. Prevalence of depression in respondents based on ICD-10 criteria was estimated. Prevalence values for four chronic physical diseases—angina, arthritis, asthma, and diabetes—were also estimated using algorithms derived via a Diagnostic Item Probability Study. Mean health scores were constructed using factor analysis and compared across diff erent disease states and demographic variables. The relation of these disease states to mean health scores was determined through regression modelling. Findings Observations were available for 245 404 participants from 60 countries in all regions of the world. Overall, 1-year prevalence for ICD-10 depressive episode alone was 3·2 % (95 % CI 3·0–3·5); for angina 4·5 % (4·3–4·8); for arthritis 4·1 % (3·8–4·3); for asthma 3·3 % (2·9–3·6); and for diabetes 2·0 % (1·8–2·2). An average of between 9·3% and 23·0 % of participants with one or more chronic physical disease had comorbid depression. This result was signifi cantly higher than the likelihood of having depression in the absence of a chronic physical disease (p<0·0001). After adjustment for socioeconomic factors and health conditions, depression had the largest eff ect on worsening

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health care have been escalating exponentially. As refer-rals continue to increase, health care organizations are encouraged to find more effective methods for provid-ing high-quality patient care with cost savings. Objective: To evaluate the use of remote video tech-nology in the home health care setting as well as the qual-ity, use, patient satisfaction, and cost savings from this technology.

Little is known about the usefulness of psychotherapeutic approaches for traumatized refugees who continue to live in dangerous conditions. Narrative exposure therapy (NET) is a short-term approach based on cognitive–behavioral therapy and testimony therapy. The efficacy of narrative exposure therapy was evaluated in a randomized controlled trial. Sudanese refugees living in a Ugandan refugee settlement (N 43) who were diagnosed as suffering from posttraumatic stress disorder (PTSD) either received 4 sessions of NET, 4 sessions of supportive counseling (SC), or psychoeducation (PE) completed in 1 session. One year after treatment, only 29 % of the NET participants but 79 % of the SC group and 80% of the PE group still fulfilled PTSD criteria. These results indicate that NET is a promising approach for the treatment of PTSD for refugees living in unsafe conditions. Experience of traumatic life events has been increasing in war-affected populations as civilians are increasingly exposed to war, torture, and forced migration. Refugees who have fled from war regions often report a number of extremely stressful experiences such as physical and psychological torture, shelling, sexual vio-lence, and other atrocities. As a consequence, high prevalence of

Currently, welfare programs coordinate a range of services to support work among welfare recipients and help them overcome barriers to employment. This paper con-siders the relationship between spatial proximity to and utilization of support serv-ices among welfare recipients. Accessibility of mental health and substance abuse service providers among welfare recipients is examined in the three-county Detroit metropolitan area and the relationship between mental health service accessibility and mental health service utilization among welfare recipients considered. Not only does access to service providers vary significantly across the metropolitan area by race and place, but these analyses reveal that greater spatial proximity to serv-ice providers increases the probability that welfare recipients will receive services. When controlling for access to providers and individual-level characteristics, we also find that African American welfare recipients are about half as likely to use mental health services as white recipients. © 2003 by the Association for Public Pol-icy Analysis and Management.

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Objective: This study investigated whether altruistic social interest behaviors such as engaging in helping others were associated with better physical and mental health in a stratified random sample of 2016 members of the Presbyterian Church throughout the United States. Methods: Mailed questionnaires evaluated giving and receiving help, prayer activities, positive and negative religious coping, and self-reported physical and mental health. Results: Multivariate regression analysis revealed no association between giving or receiving help and physical functioning, although the sample was highly skewed toward high physical functioning. Both helping others and receiving help were significant predictors of mental health, after adjusting for age, gender, stressful life events, income, general health, positive and negative religious coping, and asking God for healing (R2 .27). Giving help was a more important predictor of better reported mental health than receiving help, and feeling overwhelmed by others’ demands was an independent predictor of worse mental health in the adjusted model. Significant predictors of giving help included endorsing more prayer activities, higher satisfaction with prayer life, engaging in positive religious coping, age, female gender, and being a church elder. Frequency of prayer and negative religious coping were not related to giving help. Conclusions: Helping others is associated with higher levels of mental health, above and beyond the benefits of receiving help and other known psychospiritual, stress, and demographic factors. The links between these findings and response shift theory are discussed, and implications for clinical interventions and future research are described. Key words: social interest, altruism, social support, mental health, physical health, spirituality, stress, response shift.

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Objective: To evaluate the effect of a program of modifi ed Pilates for active indi-viduals with chronic non-specifi c low back pain. Design: A single blind random-ized controlled trial. Participants: 49 individuals with chronic low back pain were randomly allocated to control (n = 24) or Pilates group (n = 25). Thirty-four indi-viduals completed the study (14 and 20 individuals for control and Pilates group, respectively). Intervention: The Pilates group undertook a six week program of Pilates. Both groups continued with normal activity. Main Outcome Measures: An assessor blinded to group allocation conducted functional and questionnaire-based assessments pre- and post- intervention. Results: Improvements were seen in the Pilates group post- intervention period with increases (P < 0.05) in general health, sports functioning, fl exibility, proprioception, and a decrease in pain. The control group showed no signifi cant differences in the same measures post- intervention. Conclusions: These data suggest that Pilates used as a specifi c core stability exercise incorporating functional movements can improve non-specifi c chronic low back pain in an active population compared to no intervention. Additionally,