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Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke
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Augmented Cognitive Behavioral Therapy for Poststroke Depressive Symptoms: A Randomized Controlled Trial.

Joyce A Kootker1, Sascha M C Rasquin2, Frederik C Lem3

  • 1Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.

Archives of Physical Medicine and Rehabilitation
|November 17, 2016
PubMed
Summary

Individually tailored cognitive behavioral therapy (CBT) and computerized cognitive training (CCT) both improved mood and quality of life in stroke survivors. However, augmented CBT was not superior to CCT in reducing depressive symptoms poststroke.

Keywords:
AnxietyDepressionPsychologyRehabilitationStroke

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Area of Science:

  • Neurology
  • Psychiatry
  • Rehabilitation Medicine

Background:

  • Poststroke mood disorders, including depression and anxiety, are common and significantly impact patient recovery and quality of life.
  • Cognitive behavioral therapy (CBT) is a recognized treatment for mood disorders, but its effectiveness in the poststroke population requires further investigation.

Purpose of the Study:

  • To evaluate the effectiveness of individually tailored cognitive behavioral therapy (CBT), augmented with real-life activity training, compared to computerized cognitive training (CCT) for reducing depressive symptoms in patients poststroke.

Main Methods:

  • A multicenter, assessor-blinded, randomized controlled trial was conducted with 61 patients experiencing depressive symptoms at least 3 months poststroke.
  • Participants received either augmented CBT or CCT. The primary outcome was the Hospital Anxiety and Depression Scale-depression subscale (HADS-D), with secondary outcomes including participation and quality of life.

Main Results:

  • Both augmented CBT and CCT groups showed significant and persistent improvements in HADS-D scores, participation, and quality of life over 8 months.
  • No significant difference was found between the augmented CBT and CCT groups for any of the measured outcomes, indicating no superiority of augmented CBT.

Conclusions:

  • Augmented CBT was not found to be superior to CCT in treating mood disorders in the poststroke population.
  • Further research is needed to determine if both interventions offer benefits beyond the natural course of recovery.