Ranking psychological interventions for post-stroke depression: A systematic review and network meta-analysis

Area of Science:

• Neuroscience
• Psychology
• Clinical Medicine

Background:

• Post-stroke depression (PSD) is a common complication following stroke.
• Psychological interventions offer non-pharmacological treatment options for PSD.
• The optimal intervention type and long-term efficacy for varying PSD severity remain unclear.

Purpose of the Study:

• To compare the efficacy of different psychological interventions for PSD.
• To evaluate the mid- to long-term effectiveness of these interventions.
• To assess effectiveness across different levels of PSD severity.

Main Methods:

• Systematic search of seven databases for randomized controlled trials (RCTs).
• Frequentist network meta-analysis (NMA) with random effects.
• Subgroup analyses were conducted based on PSD severity.

Main Results:

• Thirty-eight RCTs with 3106 participants were analyzed.
• Third-wave therapies demonstrated significant post-intervention improvement in PSD (Hedges' g = -1.08).
• These benefits were sustained at mid- to long-term follow-up (Hedges' g = -0.82).
• Relaxation therapy was effective for mild PSD (Hedges' g = -0.77), but not for moderate-to-severe PSD.

Conclusions:

• Third-wave therapies show potential for effective and sustained PSD treatment.
• Relaxation therapy is beneficial for mild PSD, but not for more severe forms.
• High heterogeneity and low evidence certainty necessitate cautious interpretation of findings.