Yejin Lee1, Brian Chen1, Mandy W M Fong2, Jin-Moo Lee2, Ginger E Nicol3, Eric J Lenze3, Lisa T Connor4, Carolyn Baum4, Alex W K Wong5. 1. Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA. 2. Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA. 3. Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA. 4. Program in Occupational Therapy & Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA. 5. Program in Occupational Therapy, Department of Neurology & Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Abstract
OBJECTIVE: To compare the effectiveness of non-pharmacological interventions on depressive symptoms in people after stroke. DATA SOURCES: A literature search was performed through databases from January 2000 to August 2018: MEDLINE; CINAHL Plus; Scopus; Academic Search Complete; Cochrane Central Register of Controlled Trials; Scopus; and Library, Information Science and Technology Abstracts. Search terms included depression, stroke, non-pharmacologic, and intervention. STUDY SELECTION: We included randomized controlled trials comparing non-pharmacological interventions to controls for depressive symptoms in people after stroke. Of 1703 identified articles, 22 trials were included in narrative synthesis, of which 13 were eligible for meta-analysis. DATA EXTRACTION: Two reviewers extracted characteristics of participants, interventions, and results from all included trials. DATA SYNTHESIS: Thirteen interventions were categorized into four types: complementary and alternative therapy (five trials, n=228), exercise (four trials, n=263), psychosocial therapy (two trials, n=216), and multifactorial therapy (two trials, n=358). Overall beneficial effects of non-pharmacological interventions on depressive symptoms were found both post-intervention (effect size [ES] = -0.24, 95% confidence Interval [CI]: -0.37 to -0.11, p < 0.05) and at follow-up (ES = -0.22, CI: -0.36 to -0.07, p< 0.05). We found individual beneficial effects for complementary and alternative therapy (ES = -0.29, CI: -0.55 to -0.02, p < 0.05) and psychosocial therapy (ES = - 0.33, CI: -0.60 to -0.06, p < 0.05) post-intervention. CONCLUSIONS: Complementary and alternative therapy and psychosocial therapy appear to be promising strategies for improving post-stroke depression. Future studies target a personalized approach for people with specific conditions such as cognitive impairment.
OBJECTIVE: To compare the effectiveness of non-pharmacological interventions on depressive symptoms in people after stroke. DATA SOURCES: A literature search was performed through databases from January 2000 to August 2018: MEDLINE; CINAHL Plus; Scopus; Academic Search Complete; Cochrane Central Register of Controlled Trials; Scopus; and Library, Information Science and Technology Abstracts. Search terms included depression, stroke, non-pharmacologic, and intervention. STUDY SELECTION: We included randomized controlled trials comparing non-pharmacological interventions to controls for depressive symptoms in people after stroke. Of 1703 identified articles, 22 trials were included in narrative synthesis, of which 13 were eligible for meta-analysis. DATA EXTRACTION: Two reviewers extracted characteristics of participants, interventions, and results from all included trials. DATA SYNTHESIS: Thirteen interventions were categorized into four types: complementary and alternative therapy (five trials, n=228), exercise (four trials, n=263), psychosocial therapy (two trials, n=216), and multifactorial therapy (two trials, n=358). Overall beneficial effects of non-pharmacological interventions on depressive symptoms were found both post-intervention (effect size [ES] = -0.24, 95% confidence Interval [CI]: -0.37 to -0.11, p < 0.05) and at follow-up (ES = -0.22, CI: -0.36 to -0.07, p< 0.05). We found individual beneficial effects for complementary and alternative therapy (ES = -0.29, CI: -0.55 to -0.02, p < 0.05) and psychosocial therapy (ES = - 0.33, CI: -0.60 to -0.06, p < 0.05) post-intervention. CONCLUSIONS: Complementary and alternative therapy and psychosocial therapy appear to be promising strategies for improving post-stroke depression. Future studies target a personalized approach for people with specific conditions such as cognitive impairment.
Authors: Ida Babakhanyan; Noelle E Carlozzi; Benjamin S McKenna; Kaitlin B Casaletto; Allen W Heinemann; Robert K Heaton Journal: Arch Phys Med Rehabil Date: 2019-05-31 Impact factor: 3.966
Authors: Hsiu F Tsai; Ying R Chen; Min H Chung; Yuan M Liao; Mei J Chi; Chia C Chang; Kuei R Chou Journal: Cancer Nurs Date: 2014 Nov-Dec Impact factor: 2.592