Life Adaptation Skills Training (LAST) for persons with depression: A randomized controlled study

- The intervention group reduced the anxiety level and suicidal ideation.
- Both group showed significant improvement on overall quality of life.
- The intervention group had larger effect size control group.

BakgroundTo investigate the efficacy of the “Life Adaptation Skills Training (LAST)” program for persons with depression.MethodsSixty-eight subjects with depressive disorder were recruited from psychiatric outpatient clinics in Taipei city and were randomly assigned to either an intervention group (N=33), or a control group (N=35). The intervention group received 24-sessions of the LAST program, as well as phone contact mainly related to support for a total of 24 times. The control group only received phone contact 24 times. The primary outcome measure utilized was the World Health Organization Quality of Life-BREF-Taiwan version. Secondary outcome measures included the Occupational self-assessment, the Mastery scale, the Social support questionnaire, the Beck anxiety inventory, the Beck depression inventory-II, and the Beck scale for suicide ideation. The mixed-effects linear model was applied to analyze the incremental efficacy of the LAST program, and the partial eta squared (ηp2) was used to examine the within- and between- group effect size.ResultsThe subjects who participated in the LAST program showed significant incremental improvements with moderate to large between-group effect sizes on their level of anxiety (−5.45±2.34, p<0.05; ηp2=0.083) and level of suicidal ideation (−3.09±1.11, p<0.01; ηp2=0.157) when compared to the control group. The reduction of suicidal ideations had a maintenance effect for three months after the end of intervention (−3.44±1.09, p<0.01), with moderate between-group effect sizes (ηp2=0.101). Both groups showed significant improvement on overall QOL, overall health, physical QOL, psychological QOL, level of anxiety, and level of depression. The within-group effect sizes achieved large effects in the intervention group (ηp2=0.328-0.544), and were larger than that of the control group.LimitationsA small sample size in the study, a high dropout rate, lower compliance rates for the intervention group, and lacking of true control group.ConclusionsThe occupation-based LAST program, which focuses on lifestyle rearrangement and coping skills enhancement, could significantly improve the level of anxiety and suicidal ideations for persons with depression.