Living alone and living together: their significance for well-being

Differential rates of demographic change between the developed and developing nations contribute to disparate living arrangements and contrasting cultural understandings of living together and alone. Among some cohorts in the developed world, who can afford it, living alone is seen as a lifestyle choice and representative of independence, thus not compromising of wellbeing. In some contexts living arrangements have minimal impact on wellbeing. However, in parts of the developing world, and among other cohorts in developed countries, living alone represents despair, abandonment and loneliness leading to diminished wellbeing. Overriding this cultural difference is the unambiguous population level data from across the world showing that intimate partnerships, particularly marriage, provide a protective shield against low personal wellbeing scores. The jury is still out on whether this protective effect necessarily involves cohabitation. The current rise in living- apart-together relationships and the possible future trend of living together virtually, through second life and other digital media, raises further questions about the nexus between living arrangements and wellbeing

Efficacy of Bupropion for Relapse Prevention in Smokers With and Without a Past History of Major Depression

BACKGROUND: This study evaluated the efficacy of bupropion for relapse prevention in smokers with and without a past history of major depressive disorder. Changes in depressive symptoms were also examined. DESIGN: Data were gathered prospectively from a randomized, double-blind relapse prevention trial of bupropion conducted at five study sites. A total of 784 smokers (54% female, 97% white) were enrolled. Using the Structured Clinical Interview for Depression, 17% of the subjects reported a past history of major depressive disorder at baseline. All subjects received open-label bupropion SR (300 mg/d) for 7 weeks. Subjects abstinent from smoking at the end of 7 weeks (N= 429) were randomized to bupropion SR (300 mg/d) or placebo for the remainder of the year and followed for 1 year off medication. The primary outcome measures were median time to relapse to smoking and the 7-day point-prevalence smoking abstinence rate. Self-reported abstinence from smoking was verified by expired air carbon monoxide. The Beck Depression Inventory was used to assess depressive symptoms at baseline and at weeks 8 and 12. RESULTS: Median time to relapse did not differ by past history of major depressive disorder. Bupropion was associated with higher point-prevalence smoking abstinence at the end of medication compared to placebo (P= .007), independent of a past history of major depressive disorder. Moreover, change in depressive symptoms during the double-blind phase did not differ for those with and without a past history of major depressive disorder. CONCLUSIONS: Extended use of bupropion for relapse prevention is effective for smokers with and without a history of major depression