The impact of life review on depression in older adults: a randomized controlled trial.
BACKGROUND
We developed an indicated preventive life-review course, "Looking for Meaning", based on the assumption that reminiscence styles influence coping with depressive symptoms. This study describes the impact of this course in a pragmatic randomized controlled trial.


METHODS
Inclusion criteria were >50 years, a score of 5 or higher on the Center for Epidemiological Studies Depression Scale (CES-D), and no depressive disorder or psychotropic or psychological treatment. Participants were randomized and stratified by gender: the experimental group (N = 83) was offered the course and the comparison group (N = 88) a movie. There were three measurements: pre-treatment, post-treatment and 6 months after post-treatment. Depressive symptoms constituted the primary outcome. Secondary outcomes were anxiety symptoms, satisfaction with life, mastery and reminiscence styles. All analyses were conducted according to the intention-to-treat principle. Missing values were replaced by regression imputation.


RESULTS
The course reduced depressive symptoms, a decrease that was retained during follow-up. A significant between-group effect size was found (d = 0.58). There was also a reduction in symptoms of anxiety; however, the comparison group showed the same reduction, resulting in a small between-group effect size. Gender and level of depressive symptoms were found to be prognostic factors for the change in depressive symptoms; age was not. Post hoc analyses showed significant between-group effect sizes for females and those with a score above the cut-off of the CES-D.


CONCLUSIONS
The course "Looking for Meaning" can be recommended for people aged over 50 years, females and older adults with a clinically relevant level of depressive symptoms (above cut-off) in particular.
Netherlands Institute of Mental Health and Addiction, 3500 AS Utrecht, The Netherlands. APot@trimbos.nl
Anne Margriet
AM
Pot
Ernst T
ET
Bohlmeijer
Simone
S
Onrust
Anne-Sophie
AS
Melenhorst
Marjolein
M
Veerbeek
Wilma
W
De Vries
D000223:Adaptation, Psychological; D000368:Aged; D001290:Attitude; D003863:Depression / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008568:Memory; D008875:Middle Aged; D011795:Surveys and Questionnaires