title: Life Adaptation Skills Training (LAST) for persons with depression: A randomized controlled study.
abstract: BACKGROUND
  To investigate the efficacy of the "Life Adaptation Skills Training (LAST)" program for persons with depression.
  
  
  METHODS
  Sixty-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 (ηp(2)) was used to examine the within- and between- group effect size.
  
  
  RESULTS
  The 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; ηp(2)=0.083) and level of suicidal ideation (-3.09±1.11, p<0.01; ηp(2)=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 (ηp(2)=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 (ηp(2)=0.328-0.544), and were larger than that of the control group.
  
  
  CONCLUSIONS
  A small sample size in the study, a high dropout rate, lower compliance rates for the intervention group, and lacking of true control group.
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: School of Occupational Therapy, National Taiwan University, Taipei, Taiwan.
authors.forename: Yun-Ling
authors.initials: YL
authors.lastname: Chen
authors.affiliation: School of Occupational Therapy, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan Uniersity Hospital, Taipei, Taiwan. Electronic address: aywoan@ntu.edu.tw.
authors.forename: Ay-Woan
authors.initials: AW
authors.lastname: Pan
authors.affiliation: Department of Social Worker, National Taiwan University, Taipei, Taiwan.
authors.forename: Ping-Chuan
authors.initials: PC
authors.lastname: Hsiung
authors.affiliation: Department of Statistics, National Taipei University, New Taipei City, Taiwan.
authors.forename: Lyinn
authors.initials: L
authors.lastname: Chung
authors.affiliation: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA.
authors.forename: Jin-Shei
authors.initials: JS
authors.lastname: Lai
authors.affiliation: Department of Psychiatry, National Taiwan Uniersity Hospital, Taipei, Taiwan.
authors.forename: Susan
authors.initials: S
authors.lastname: Shur-Fen Gau
authors.affiliation: Department of Mechanical Engineering, Lung-Hwa University of Science and Technology, Tao-Yuan, Taiwan.
authors.forename: Tsyr-Jang
authors.initials: TJ
authors.lastname: Chen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy; D003376:Counseling / Q000379:methods* / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation / Q000379:methods* / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D059020:Suicidal Ideation; D013624:Taiwan; D016896:Treatment Outcome; D055815:Young Adult
keywords: Depressive disorder; Manualized occupational therapy program; Quality of life