Delivering Psychological Intervention for Patients With Poststroke Depression: Can Short Treatment Help During Inpatient Rehabilitation?

Abstract

Depression and anxiety are common after stroke and can significantly impact a stroke survivor’s health outcomes. The aims of this Australian pilot study were to (a) screen stroke patients for depression and anxiety on admission to inpatient rehabilitation, (b) introduce short-term psychological intervention (four sessions) and access if distressed patients engaged and showed preliminary effectiveness in reducing symptoms of depression and anxiety and improving quality of life, and (c) evaluate if symptoms remained stable after discharge from hospital. Mood screening of 115 patients admitted poststroke identified 29 with elevated symptoms, who subsequently received short-term (three to four sessions) cognitive behavior therapy. Mood screening was challenging on the wards with only 44% able to engage in the process. Before and after treatment showed a significant reduction in the scores for depression (7.7 to 5.0) and anxiety (9.5 to 5.5). These lower scores were sustained 1 month after discharge. Screening for depression and anxiety poststroke helps identify patients earlier in their rehabilitation journey but is challenging to implement and missed detection for many. This study found patients engaged in the therapeutic process with good outcomes, but cognitive and physical impairments must be considered when engaging stroke patients in psychology.