The Effectiveness of Cognitive Behavioral Therapy for People with Depression Following Stroke: A Systematic Review and Meta-Analysis

Abstract

Post-stroke depression (PSD) is a common psychiatric manifestation of stroke, which has a devastating impact on survivors' quality of life with an increasing burden on caregivers and the public medical system. Even so, no meta-analysis on specific psychotherapeutic treatment has been conducted. How effective is cognitive behavioral therapy (CBT) in reducing depressive symptoms in randomized-controlled trials (RCTs) targeting community-dwelling stroke survivors with PSD? Through systematic procedures of screening and data extraction, four RCTs were synthesized for meta-analysis (N= 270) on effect size estimates. Overall, CBT groups showed significant improvement in depression compared with controls. Methodological quality, intensity of CBT, and duration of post-treatment follow-up proved critical to treatment effects. Despite the potential threat of external validity, this paper had reviewed their content comprehensively with the implication of facilitating public understanding, research, and service development of PSD using CBT. To fill the knowledge gap, standardized protocol and further subgroup analyses are necessary.