title: Different interventions for post-ischaemic stroke depression in different time periods: a single-blind randomized controlled trial with stratification by time after stroke.
abstract: OBJECTIVE
  To determine the appropriate treatments for post-ischaemic stroke depression at different times after stroke.
  
  
  METHODS
  A single-blind, randomized, controlled trial that compared three intervention groups, with subgroups stratified by time after stroke.
  
  
  METHODS
  Outpatient clinic.
  
  
  METHODS
  Eligible patients were recruited at discharge ( n = 73) and three ( n = 67), six ( n = 65), and nine months ( n = 69) after discharge, and patients completed mood questionnaires.
  
  
  METHODS
  Patients were randomly distributed into three groups: Group A received placebos and participated in general discussions; Group B, received citalopram and participated in general discussions; and Group C, received placebos and underwent cognitive behavioural therapy. All three groups participated in rehabilitation during three months of follow-up.
  
  
  METHODS
  Outcome was assessed three months after baseline using the 17-item Hamilton Depression Scale (HAMD17) and the Bech-Rafaelsen Melancholia Scale (MES). During treatment, the Udvalg for Kliniske Undersogelser side-effect scale was also administered.
  
  
  RESULTS
  When stratification was not considered, the scores of Group B on the Melancholia Scale were lower than those of Group A ( P = 0.02); when the four time-based subgroups were analysed, significant differences were observed between Groups A and B (PMES= 0.02, PHAMD17= 0.02) in the group recruited six months after discharge and between Groups A and C (PMES= 0.01) in the last time period nine months after discharge.
  
  
  CONCLUSIONS
  The effects of citalopram or cognitive behavioural therapy is similar to the effect of rehabilitation alone for early-onset post-ischaemic depression; rehabilitation and citalopram for delayed-onset post-ischaemic depression; and rehabilitation and cognitive behavioural therapy for late-onset post-ischaemic depression are more effective than rehabilitation alone.
authors.affiliation: Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Gao
authors.affiliation: Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Meiqing
authors.initials: M
authors.lastname: Lin
authors.affiliation: Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Jiuhan
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Siwei
authors.initials: S
authors.lastname: Bi
authors.affiliation: Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Ziyan
authors.initials: Z
authors.lastname: Ni
authors.affiliation: Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Xiuli
authors.initials: X
authors.lastname: Shang
mesh_terms: D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D002545:Brain Ischemia / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation; D015283:Citalopram / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy; D016037:Single-Blind Method; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram
keywords: Depression; antidepressive agents; psychotherapy; rehabilitation; stroke