Brief psychosocial-behavioral intervention with antidepressant reduces poststroke depression significantly more than usual care with antidepressant: living well with stroke: randomized, controlled trial.
OBJECTIVE
Depression after stroke is prevalent, diminishing recovery and quality of life. Brief behavioral intervention, adjunctive to antidepressant therapy, has not been well evaluated for long-term efficacy in those with poststroke depression.


METHODS
One hundred one clinically depressed patients with ischemic stroke within 4 months of index stroke were randomly assigned to an 8-week brief psychosocial-behavioral intervention plus antidepressant or usual care, including antidepressant. The primary end point was reduction in depressive symptom severity at 12 months after entry.


RESULTS
Hamilton Rating Scale for Depression raw score in the intervention group was significantly lower immediately posttreatment (P<0.001) and at 12 months (P=0.05) compared with control subjects. Remission (Hamilton Rating Scale for Depression <10) was significantly greater immediately posttreatment and at 12 months in the intervention group compared with the usual care control. The mean percent decrease (47%+/-26% intervention versus 32%+/-36% control, P=0.02) and the mean absolute decrease (-9.2+/-5.7 intervention versus -6.2+/-6.4 control, P=0.023) in Hamilton Rating Scale for Depression at 12 months were clinically important and statistically significant in the intervention group compared with control.


CONCLUSIONS
A brief psychosocial-behavioral intervention is highly effective in reducing depression in both the short and long term.
Mitchell
Pamela H
PH
Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA 98195-7266, USA. pmitch@u.washington.edu
Veith
Richard C
RC
Becker
Kyra J
KJ
Buzaitis
Ann
A
Cain
Kevin C
KC
Fruin
Michael
M
Tirschwell
David
D
Teri
Linda
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000008:administration & dosage*; D003863:Depression / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D020521:Stroke; D013997:Time Factors
D000928:Antidepressive Agents