The effectiveness of cognitive behavioural therapy in reducing post-stroke depression

Abstract

Background: Post-stroke depression (PSD) is a neuropsychiatric complication that affects one third of stroke survivors, causing limitations on a daily basis due to sensorimotor and behavioural damages. When an individual has several comorbidities and suffers from PSD, serious complications may occur which could lead to severe functional impairment, and increases the risks of another stroke onset. Having an appropriate treatment for PSD helps to enhance the rate of recovery and can save longterm supplementary treatments. However, due to the underdiagnosis of the disorder, only a few patients are entitled to the appropriate treatment, despite the high prevalence rates of PSD. For this reason, the following PICO question was expressed: “Amongst adults with post-stroke depression (PSD) (P), does cognitive behavioural therapy (CBT) (I), compared to pharmaceutical therapies (C) improve depressive symptoms (O)? Methods: Through the utilisation of keywords, in combination with search tools and limiters, electronic databases were examined to be able to conduct a literature search related to the research question. Studies which recruited individuals under the age of 18, included other forms of psychotherapy or any other mental disorders, were excluded. The inclusion criteria applied comprised of randomised controlled trials (RCTs) and systematic reviews written in English and published within the last 10 years, recruitment of adults over the age of 18, and academic journals. The CASP (Critical Appraisal Skills Programme) tool was utilised to appraise the retrieved literature, and to assess the studies’ validity and reliability within practice. Results: The key studies comprised of four RCTs, two systematic reviews, and one meta-analysis. Research findings varied between the key studies, however few articles reported significant findings amongst individuals with PSD when exposed to CBT. Some of the articles concluded that CBT alone or when combined with pharmaceutical therapy, depressive moods were improved. Methodological limitations were also present in all key studies, which could have impacted the results. Implications and Recommendations: Recommendations for further research include of using larger sample sizes, and recruiting participants during high-risk periods, given that the study is examining psychological interventions. Further education on mental disorders should be implemented to the general public to better improve the quality of life of individuals with mental disorders.