A Brief Behavioral Intervention Can Reduce Depression in Stroke Survivors (2)
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“In designing LWWS, we reasoned that changing the behaviors commonly associated with depression through an individualized counseling program would lead to a more effective and longer-lasting elevation of mood than is often seen with medications alone,” said Dr. Pamela Mitchell, the principal investigator of the study.
“Individuals who have suffered a stroke often must make adaptations in their lives and learn to cope with new limitations, both physical and cognitive. Depression during the recovery period can interfere with their ability to fully engage in their treatment regimen or return to family and work,” noted Dr. Patricia A. Grady, the NINR Director.
Depression scores in the LWWS group were significantly lower after treatment and at a one year follow-up compared to the control group. In addition, more participants in the LWWS group achieved remission — with scores no longer meeting the criteria for depression — compared to the control group both immediately after treatment (47 percent vs. 19 percent), and at a one-year follow-up (48 percent vs. 27 percent). At two years, depression scores continued to decrease and remission rates continued to increase for both groups, although the gap narrowed so that the differences were no longer statistically significant.
For both the intervention and control groups, patients in remission at one year had significantly higher scores in perceived ability, recovery, and social participation than those who were not.
“The success of LWWS shows the importance of including behavioral strategies in the care of stroke survivors. We believe our study is the first to report a clinically significant reduction in depression in these patients over a long term,” said Dr. Mitchell. “We also showed that achieving remission from depression by any means is an important treatment goal that could promote recovery and sociability.”
“This study has the potential to add another tool for health care professionals to use in helping individuals cope following a stroke,” added Dr. Grady. “Also of note, the LWWS program included instruction to help family members and other informal caregivers identify resources and support services as a way to reduce their caregiving burden, an important aspect of comprehensive post-stroke care.”
NINR supports basic and clinical research that develops the knowledge to build the scientific foundation for clinical practice, prevent disease and disability, manage and eliminate symptoms caused by illness, and enhance end-of-life and palliative care. For more information about NINR, visit the Web site at www.ninr.nih.gov.