Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of First Stroke Attack in Ibadan, Nigeria

Abstract

Background and Purpose Poststroke depression (PSD) is a common complication after stroke. There is no adequate treatment for PSD. This study examined efficacy of cognitive rehabilitation therapy (CRT) in the treatment of PSD among stroke survivors. Methods An experimental design, 30 participants with poststroke depression were randomly assigned into 3 groups of cognitive rehabilitation therapy (CRT), psychoeducation (PE), and the control group (CG). CRT consisted of nine sessions with three-phased sessions focusing on activity stimulation, negative thoughts, and people contacts, PE consisted of nine sessions focusing on knowledge on stroke and poststroke depression, and the CG group was on the waiting list. The BDI scale was used for assessing PSD at posttest. Results There was a significant difference in the efficacy of CRT, PE, and the CG on PSD, with CRT–CG mean difference of −9.4 ± 3.11 and PE–CG 1.0 ± 3.83. Furthermore, stress was not a confounding variable on the efficacy of CRT. The type of therapy significantly influenced PSD at posttest, with the CRT having greater mean reduction to CG (−11.1 ± 3.1) than PE to the CG (3.0 ± 3.8). Conclusions Cognitive rehabilitation therapy significantly reduced poststroke depression. Hence, it should be integrated as an adjunct treatment of poststroke depression.

The Impact of Depression on the Functional Outcome of the Elderly Stroke Victim from a Gender Perspective: A Systematic Review

“…The sample size of the included studies is a variable that stands out in this systematic review. Excepting the clinical trial by Taravati et al [ 36 ] with n = 37, the clinical trial by Olukolade and Osinowo [ 40 ] with n = 30, and the one by Chun et al [ 42 ] with n = 59, the rest presented a sample size equal to or greater than 60 patients.…”

“…Olukolade and Osinowo [ 40 ], Kongkasuwan et al [ 43 ] and Zhang et al [ 34 ], and Wang et al [ 38 ] highlighted the importance of diagnosing and treating post-stroke depression to improve the rehabilitation process and increasing patients’ quality of life, leading to a greater and more effective recovery.…”

The Relationship Between 5-Hydroxytryptamine and Its Metabolite Changes With Post-stroke Depression

“…If patients are diagnosed with PSD, they are usually treated with antidepressants ( 183 ). However, the effectiveness of antidepressants in clinical practice is only approximately 50% ( 184 ).…”

A Narrative Review on the Non-Pharmacologic Interventions in Post-Stroke Depression

“… 30 A prospective observational study in Nigeria also showed that, after nine sessions of CBT focused on activity stimulation, negative thoughts and people contacts, patients with PSD had better emotional well-being compared to controls. 31 Computerized CBT has also been explored in the past but did not prove superior over conventional CBT although only feasibility trials and studies with small population are available to date. 32 , 33 There is also an ongoing RCT on the use of an CBT-based iPAD application promoting self-reinforcement and positivity being performed among Japanese patients.…”