Cognitive Behavioral Psychotherapy for Depression Following Stroke

Background and Purpose—There is inconclusive evidence of the effectiveness of psychological interventions for depression after stroke. We report the results from a randomized controlled trial of cognitive behavioral therapy (CBT). Methods—Stroke patients admitted to hospital were invited to complete mood questionnaires 1, 3 and 6 months after stroke. Patients who were depressed were invited to take part in a trial and randomly allocated to receive CBT (n 39), an attention placebo intervention (n 43), or standard care (n 41). Outcome assessments were undertaken at 3 and 6 months after recruitment, on the Beck Depression Inventory, Wakefield Depression Inventory, Extended Activities of Daily Living scale, London Handicap Scale, and a rating of satisfaction with care. Results—There were no significant differences between the groups in patients’ mood, independence in instrumental activities of daily living, handicap, or satisfaction with care. Conclusions—CBT in the treatment of depression following stroke was found to be ineffective in this study. However, because of the small sample size, method of recruitment, and selection criteria, further randomized trials are required. (Stroke. 2003;34:111-115.)