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Cognitive behavioral therapy for post-stroke depression: A meta-analysis.

Shi-Bin Wang1, Yuan-Yuan Wang2, Qing-E Zhang3

  • 1Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.

Journal of Affective Disorders
|April 29, 2018
PubMed
Summary
This summary is machine-generated.

Cognitive behavioral therapy (CBT) significantly improves post-stroke depression (PSD) symptoms, showing positive effects alone or with antidepressants. However, further high-quality trials are needed to confirm these findings due to study limitations.

Keywords:
Cognitive behavioral therapyMeta-analysisPost-stroke depression

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Rehabilitation Medicine

Background:

  • Post-stroke depression (PSD) is a common complication affecting patient recovery.
  • Cognitive behavioral therapy (CBT) is a potential intervention for PSD, but existing evidence is inconsistent.
  • This meta-analysis synthesizes findings from randomized controlled trials (RCTs) to evaluate CBT's efficacy in treating PSD.

Purpose of the Study:

  • To systematically evaluate the effectiveness of Cognitive Behavioral Therapy (CBT) for Post-Stroke Depression (PSD).
  • To analyze the impact of CBT on depressive symptoms, remission rates, and functional outcomes in PSD patients.
  • To identify factors influencing CBT's effectiveness in PSD based on study characteristics.

Main Methods:

  • A systematic search of English and Chinese databases (PubMed, PsycINFO, Embase, WanFang, CNKI, SinoMed) was conducted.
  • Random effects models were used to calculate weighted and standardized mean differences (WMDs/SMDs) and risk ratios (RRs) with 95% confidence intervals (CIs).
  • Twenty-three randomized controlled trials (RCTs) involving 1,972 participants with PSD were included in the analysis.

Main Results:

  • CBT demonstrated a significant positive effect on reducing depressive symptoms in PSD patients (SMD = -0.83, P < 0.001).
  • Both CBT alone (SMD = -0.76, P = 0.001) and CBT combined with antidepressants (SMD = -0.95, P < 0.00001) were effective.
  • CBT significantly improved depression remission rates (RR = 1.76, P < 0.00001), response rates (RR = 1.41, P < 0.00001), and functional outcomes.

Conclusions:

  • This meta-analysis indicates that CBT is effective in managing depressive symptoms and improving outcomes in patients with PSD.
  • However, the overall evidence quality is limited by the included studies, necessitating caution in interpretation.
  • Future high-quality RCTs are recommended to definitively establish the benefits of CBT for PSD.