Treatment-resistant depression in late life

Treatment resistance is reported in up to 40% of older patients with major depression. Before labeling an episode of depression as treatment resistant, it is important to ensure that the diagnosis is correct and that the patient has received and adhered to an adequate dose of treatment for an appropriate length of time. It is also important to assess the patient for comorbid physical and psychiatric conditions that can contribute to treatment resistance. In patients who do not experience remission of symptoms with an adequate trial of medication, the following options can be considered: augmenting the antidepressant with a drug that is not primarily an antidepressant, adding a second antidepressant to the first, switching to a different antidepressant medication, or switching to electroconvulsive therapy. This paper reviews the concept of treatment-resistant depression and discusses its assessment and management in the elderly. The author concludes that when a systematic stepped-care approach to treatment is followed, most older patients with major depression will experience remission of symptoms.     

Psychosocial and health-related characteristics of religious well-being

This investigation examined the relationship between religions well-being and eight psychosocial and health-related characteristics. This study assessed the hypothesis that religious well-being is related to overall health. Participants were 462 college students at two separate colleges in the Pacific Northwest. Analysis showed those subjects scoring higher on the measure of religious well-being scored lower on indices like loneliness and hopelessness and higher on self-esteem. Alcohol and drug use also differed significantly between the high and the low, religious well-being groups.     

Patterns of problem‐solving in children's literacy and arithmetic

Patterns of problem‐solving among 5‐to‐7 year‐olds' were examined on a range of literacy (reading and spelling) and arithmetic‐based (addition and subtraction) problem‐solving tasks using verbal self‐reports to monitor strategy choice. The results showed higher levels of variability in the children's strategy choice across Years 1 and 2 on the arithmetic (addition and subtraction) than literacy‐based tasks (reading and spelling). However, across all four tasks, the children showed a tendency to move from less sophisticated procedural‐based strategies, which included phonological strategies for reading and spelling and counting‐all and finger modelling for addition and subtraction, to more efficient retrieval methods from Years 1 to 2. Distinct patterns in children's problem‐solving skill were identified on the literacy and arithmetic tasks using two separate cluster analyses. There was a strong association between these two profiles showing that those children with more advanced problem‐solving skills on the arithmetic tasks also showed more advanced profiles on the literacy tasks. The results highlight how different‐aged children show flexibility in their use of problem‐solving strategies across literacy and arithmetical contexts and reinforce the importance of studying variations in children's problem‐solving skill across different educational contexts.