Behavioural activation therapy for post-stroke depression: the BEADS feasibility RCT

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Psychology

Background:

• Post-stroke depression (PSD) lacks sufficient evidence regarding psychological therapy effectiveness and cost-effectiveness.
• Behavioural Activation (BA) is a potential intervention for PSD.

Purpose of the Study:

• To assess the feasibility of a definitive trial for BA versus usual care in treating PSD.
• To evaluate clinical effectiveness and cost-effectiveness of BA for PSD.

Main Methods:

• A parallel-group, feasibility, multicentre, randomised controlled trial.
• Included nested qualitative research and health economic evaluation.
• Participants received up to 15 BA sessions over 4 months or usual care.

Main Results:

• Recruitment rate was 1.8 participants/centre/month; target not met.
• BA group showed a statistically significant reduction in depression scores (PHQ-9) at 6 months (-3.8 points).
• BA was acceptable to participants, carers, and therapists; definitive trial estimated at 580-623 participants.

Conclusions:

• The Behavioural Activation Therapy for Depression after Stroke trial is feasible for most outcomes.
• Recruitment rate and site capacity for a definitive trial require further investigation.
• Value-of-information analysis suggests a definitive trial is warranted.