***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Depression is a worldwide problem warranting global solutions to tackle it . Enhancing well-being has benefits in its own right and could be a good strategy for preventing depression . Providing well-being interventions via the Internet may have synergetic effects . Objective Psyfit ( “ mental fitness online ” ) is a fully automated self-help intervention to improve well-being based on positive psychology . This study examines the clinical effects of this intervention . Methods We conducted a 2-armed r and omized controlled trial that compared the effects of access to Psyfit  for 2 months ( n=143 ) to a waiting-list control condition ( n=141 ) . Mild to moderately depressed adults in the general population seeking self-help were recruited . Primary outcome was well-being measured by Mental Health Continuum-Short Form ( MHC-SF ) and WHO Well-being Index ( WHO-5 ) ; secondary outcomes were depressive symptoms , anxiety , vitality , and general health measured by Center for Epidemiological Studies Depression Scale ( CES-D ) , Hospital Anxiety and Depression Scale Anxiety subscale ( HADS-A ) , and Medical Outcomes Study -Short Form ( MOS-SF ) vitality and general health subscales , respectively . Online measurements were taken at baseline , 2 months , and 6 months after baseline . Results The  dropout rate was 37.8 % in the Psyfit group and 22.7 % in the control group . At 2-month follow-up , Psyfit tended to be more effective in enhancing well-being ( nonsignificantly for MHC-SF : Cohen ’s d=0.27 , P=.06 ; significantly for WHO-5 : Cohen ’s d=0.31 , P=.01 ) , compared to the waiting-list control group . For the secondary outcomes , small but significant effects were found for general health ( Cohen ’s d=0.14 , P=.01 ) , vitality ( d=0.22 , P=.02 ) , anxiety symptoms ( Cohen ’s d=0.32 , P=.001 ) , and depressive symptoms ( Cohen ’s d=0.36 , P=.02 ) . At 6-month follow-up , there were no significant effects on well-being ( MHC-SF : Cohen ’s d=0.01 , P=.90 ; WHO-5 : Cohen ’s d=0.26 , P=.11 ) , whereas depressive symptoms ( Cohen ’s d=0.35 , P=.02 ) and anxiety symptoms ( Cohen ’s d=0.35 , P=.001 ) were still significantly reduced compared to the control group . There was no clear dose – response relationship between adherence and effectiveness , although some significant differences appeared across most outcomes in favor of those completing at least 1 lesson in the intervention . Conclusions This study shows that an online well-being intervention can effectively enhance well-being ( at least in the short-term and for 1 well-being measure ) and can help to reduce anxiety and depression symptoms . Further research should focus on increasing adherence and motivation , reaching and serving lower-educated people , and widening the target group to include people with different levels of depressive symptoms . Trial Registration Netherl and s Trial Register ( NTR ) number : NTR2126 ; http://www.trialregister.nl/trialreg/admin/ rct view.asp?TC=2126 ( archived by WebCite at http://www.webcitation.org/6IIiVrLcO ) BACKGROUND Little is known about the cost-effectiveness of preventing mental disorders . AIMS To study the cost-effectiveness of care as usual plus minimal contact psychotherapy relative to usual care alone in preventing depressive disorder . METHOD An economic evaluation was conducted alongside a r and omised clinical trial . Primary care patients with sub-threshold depression were assigned to minimal contact psychotherapy plus usual care ( n=107 ) or to usual care alone  ( n=109 ) . RESULTS Primary care patients with sub-threshold depression benefited from minimal contact psychotherapy as it reduced the risk of developing a full-blown depressive disorder from 18 % to 12 % . In addition , this intervention had a 70 % probability of being more cost-effective than usual care alone . A sensitivity analysis indicated the robustness of these results . CONCLUSIONS Over 1 year adjunctive minimal contact psychotherapy  improved outcomes and generated lower costs . This intervention is therefore superior to usual care alone in terms of cost-effectiveness BACKGROUND There is increasing awareness of the prognostic value of residual symptomatology in affective disorders and of the need for specific therapeutic strategies in this phase of illness . The aims of the study were to apply a novel , short-term psychotherapeutic approach for increasing well-being , based on Ryff 's conceptual model , to remitted patients with affective disorders and to compare the results with those obtained with symptom-oriented cognitive behavioural strategies . METHODS Twenty patients with affective disorders ( major depression , panic disorder with agoraphobia , social phobia , generalized anxiety disorder , obsessive-compulsive disorder ) who had been successfully treated by behavioural or pharmacological methods  were r and omly assigned to a well-being enhancing therapeutic strategy ( well-being therapy ) or cognitive-behavioural treatment of residual symptoms . RESULTS Both well-being and cognitive-behavioural therapies were associated with a significant reduction of residual symptoms . However , a significant advantage of well-being therapy over cognitive-behavioural strategies was observed with observer-rated methods . DISCUSSION These preliminary results suggest the feasibility of well-being therapy in the residual stage of affective disorders . Further research should determine its value as a relapse-preventive strategy in specific mood and anxiety disorders BACKGROUND Negative emotions are linked to the onset and development of coronary heart diseases ( CHD ) , whereas positive emotions are associated with better health and lower mortality rates among patients with these diseases . The objective of this r and omised trial was to improve cardiac patients ' emotional states using a Programme to Improve Well-being ( PIW ) based exclusively on positive interventions ( those that promote intentional behaviours and thoughts to improve well-being ) . METHODS Cardiac patients ( n = 108 ) were r and omly assigned to two parallel groups . In the control group , they participated in only a Cardiac Rehabilitation Programme ( CRP group ) , whereas the intervention group also participated in the PIW ( CRP+PIW group ) . Physical functional capacity , depressive symptoms , hostility , and negative and positive affect were assessed at T1 ( baseline ) and T2 ( 8 weeks later ) . RESULTS At T2 , after controlling for functional capacity , the CRP+PIW group reported a significantly less negative affect than the CRP group . Moreover , the CRP group did not change from T1 to T2 , whereas the CRP+PIW group reported more positive emotions and fewer negative emotions and hostility at T2 than at T1 . CONCLUSIONS Positive interventions effectively improve the emotional state of cardiac patients . We suggest that specific modules should be included in the CRP to improve well-being Optimists ( people who have positive expectations about the future ) have been shown to perform more health-promoting behaviors than pessimists . This study attempts to alter individuals ’ levels of optimism , and thereby their health behaviors , by having them write about a positive future . HIV-infected women ( N = 40 ) on combination therapies  were r and omly assigned to write about a positive future or assigned to a no-writing control group . Among participants who were low in optimism , the writing intervention led to increased optimism , a trend toward increased self-reported adherence to medications , and decreased distress from medication side effects , compared to controls who did not write . Participants who were high in optimism showed the opposite effects after writing about the future . Results suggest that a future-oriented writing intervention may be a promising technique to increase medication adherence and decrease symptom , distress in pessimistic individuals BACKGROUND Positive psychologic characteristics have been linked to superior cardiac outcomes . OBJECTIVE Accordingly , in this exploratory study , we assessed positive psychology interventions in patients who had recently undergone a procedure to treat cardiovascular disease . METHOD Participants were r and omly assigned to receive 1 of 3 different 6-week face-to-face interventions or a wait-list control condition . We assessed intervention feasibility and compared changes in psychologic outcome measures postintervention ( 7wk ) and at follow-up ( 15wk ) between intervention and control participants . Across the interventions , 74 % of assigned sessions were completed . RESULTS When comparing outcomes between interventions and control participants ( N = 55 total ) , there were no between-group differences post-intervention , but at follow-up intervention participants had greater improvements in happiness ( β = 14.43 , 95 % CI : 8.66 - 20.2 , p < 0.001 ) , depression ( β = -3.87 , 95 % CI : -7.72 to 0.02 , p = 0.049 ) , and hope ( β = 7.12 , 95 % CI : 1.25 - 13.00 , p = 0.017 ) , with moderate-large effect sizes . Efficacy of the 3 interventions was similar . CONCLUSIONS Future studies are needed to identify an optimal positive psychology intervention for cardiac patients OBJECTIVE This pilot study aim ed to provide supportive evidence for the acceptability and usefulness of the Meaning-Making intervention ( MMi ) in patients newly diagnosed with Stage III or IV ovarian cancer , and to provide estimates of parameters needed to design a full-scale study . METHODS A r and omized controlled trial with 24 patients ( 12 experimental and 12 control ) was conducted . Existential well-being ( primary outcome ) , overall quality of life , distress , anxiety , depression and self-efficacy were measured . RESULTS Compared to the control group , patients in the experimental group had a better sense of meaning in life at one and three months post-intervention . CONCLUSION The MMi seems a promising intervention for advanced cancer patients , and a full r and omized controlled trial is warranted to further investigate its efficacy OBJECTIVE Adoption of effective treatments for recurrent binge-eating disorders depends on the balance of costs and benefits . Using data from a recent r and omized controlled trial , we conducted an incremental cost-effectiveness analysis ( CEA ) of a cognitive-behavioral therapy guided self-help intervention ( CBT-GSH ) to treat recurrent binge eating compared to treatment as usual ( TAU ) . METHOD Participants were 123 adult members of an HMO ( mean age = 37.2 years , 91.9 % female , 96.7 % non-Hispanic White ) who met criteria for eating disorders involving binge eating as measured by the Eating Disorder Examination ( C. G. Fairburn & Z. Cooper , 1993 ) . Participants were r and omized either to treatment as usual ( TAU ) or to TAU plus CBT-GSH . The clinical outcomes were binge-free days and quality -adjusted life years ( QALYs ) ; total societal cost was estimated using costs to patients and the health plan and related costs . RESULTS Compared to those receiving TAU only , those who received TAU plus CBT-GSH experienced 25.2 more binge-free days and had lower total societal costs of $ 427 over 12 months following the intervention ( incremental CEA ratio of -$20.23 per binge-free day or -$26,847 per QALY ) . Lower costs in the TAU plus CBT-GSH group were due to reduced use of TAU services in that group , result ing in lower net costs for the TAU plus CBT group despite the additional cost of CBT-GSH . CONCLUSIONS Findings support CBT-GSH dissemination for recurrent binge-eating treatment Positive psychology has flourished in the last 5 years . The authors review recent developments in the field , including books , meetings , courses , and conferences . They also discuss the newly created classification of character strengths and virtues , a positive complement to the various editions of the Diagnostic and Statistical Manual of Mental Disorders ( e. g. , American Psychiatric Association , 1994 ) , and present some cross-cultural findings that suggest a surprising ubiquity of strengths and virtues . Finally , the authors focus on psychological interventions that increase individual happiness . In a 6-group , r and om-assignment ,  placebo-controlled Internet study , the authors tested 5 purported happiness interventions and 1 plausible control exercise . They found that 3 of the interventions lastingly increased happiness and decreased depressive symptoms . Positive interventions can supplement traditional interventions that relieve suffering and may someday be the practical legacy of positive psychology Positive affect predicts improved glycemic control and longevity in adults with type 2 diabetes . We tested Developing Affective HeaLth to Improve Adherence ( DAHLIA ) , a self-paced online intervention for type 2 diabetes that teaches positive affect skills such as savoring , gratitude , and acts of kindness . Participants ( n = 49 ) were r and omized to the five-week DAHLIA course or an emotion-reporting wait-list control . DAHLIA was understood and accepted by participants and showed good retention ( 78 % ) . At post-intervention , DAHLIA participants showed a significantly greater decrease in depression than controls ( −4.3 vs. + 0.6 points on the CES-D , p = 0.05 ) . Secondary analyses found that this effect was considerably stronger in intervention recipients recruited online than those recruited in person . Intervention recipients recru 
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Effect sizes for stress were not significant .
Conclusion These findings indicate that PPIs , wherein the focus is on eliciting positive feelings , cognitions or behaviors , not only have the potential to improve well-being , but can also reduce distress in population s with clinical disorders .