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.