Articlegold2010

The impact of life review on depression in older adults: a randomized controlled trial

Anne Margriet Pot · Ernst Thomas Bohlmeijer · Simone Arianne Onrust · Anne-Sophie Melenhorst · Marjolein Veerbeek · Wilma De Vries

80 citations0/0 files storedInternational Psychogeriatrics

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Aging and Gerontology Research Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Identity, Memory, and Therapy

Abstract

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. CONCLUSION: 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.

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References

1977The CES-D Scale 1983The Hospital Anxiety and Depression Scale 1998The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10 1978The Structure of Coping 1998The mini international neuropsychiatric interview 1994Reducing Risks for Mental Disorders 1993The efficacy of psychological, educational, and behavioral treatment: Confirmation from meta-analysis.1963The Life Review: An Interpretation of Reminiscence in the Aged

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2014Managing depression in older age: Psychological interventions 2014Psychotherapy for subclinical depression: meta-analysis 2016Effect of psychotherapy for depression on quality of life: meta-analysis 2017The effects of life review interventions on spiritual well-being, psychological distress, and quality of life in patients with terminal or advanced cancer: A systematic review and meta-analysis of randomized controlled trials 2012The Relationship Between Time Perspective and Subjective Well-being of Older Adults

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