Different interventions for post-ischaemic stroke depression in different time periods: a single-blind randomized controlled trial with stratification by time after stroke
| Autor: | Siwei Bi, Meiqing Lin, Xiuli Shang, Jiuhan Zhao, Ziyan Ni, Jie Gao |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Psychological intervention Physical Therapy Sports Therapy and Rehabilitation Citalopram Brain Ischemia law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Ischaemic stroke Humans Medicine Single-Blind Method 030212 general & internal medicine Stroke Depression (differential diagnoses) Aged Depressive Disorder Rehabilitation business.industry Stroke Rehabilitation Middle Aged medicine.disease Psychotherapy Treatment Outcome Mood Physical therapy Antidepressive Agents Second-Generation Female business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Clinical Rehabilitation. 31:71-81 |
| ISSN: | 1477-0873 0269-2155 |
| DOI: | 10.1177/0269215515626232 |
| Popis: | Objective: To determine the appropriate treatments for post-ischaemic stroke depression at different times after stroke. Design: A single-blind, randomized, controlled trial that compared three intervention groups, with subgroups stratified by time after stroke. Setting: Outpatient clinic. Subjects: 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. Interventions: 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. Main measures: 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. |
| Databáze: | OpenAIRE |
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