Department of Neurology, General Hospital of the Yangtze River Shipping (Wuhan Brain Hospital), Wuhan, China.
Department of Critical Care Medicine, Ezhou Central Hospital, Ezhou, China.
Psychogeriatrics. 2024 Jul;24(4):983-992. doi: 10.1111/psyg.13125. Epub 2024 Apr 17.
The post-stroke period is associated with a lot of sequelae, including depression, decreased quality of life, and decline of cognitive function. Apart from the pharmacotherapy, it is also important to find a non-pharmacological treatment to relieve the sequelae. Cognitive behavioural therapy (CBT) might be a potential candidate, which can be clarified by a systematic review and meta-analysis. The eligible criteria of enrolled studies in the systematic review and meta-analysis were the randomised clinical trials (RCTs) using CBT to treat post-stroke depression, or with the focus on quality of life or cognitive function in the post-stroke period. The endpoint scores of depression, quality of life, and cognitive function scales were the targeted outcome for the final meta-analysis in the random effects model. Ten RCTs with 432 post-stroke patients receiving CBT and 385 controls were included. The meta-analysis results showed significant improvements in depression severity and quality of life. However, no significant difference between CBT and control groups was found in cognitive function. In addition, significant heterogeneity was derived from the meta-analysis. According to the meta-analysis results, CBT might be beneficial for relieving depression severity and improving quality of life. However, cognitive function might not be influenced by CBT. Further studies with a more consistent CBT design with greater sample sizes should be warranted to clarify and confirm the treatment effects of CBT for post-stroke depression and quality of life.
脑卒中后会遗留很多后遗症,包括抑郁、生活质量下降和认知功能下降等。除了药物治疗,寻找非药物治疗方法来缓解后遗症也很重要。认知行为疗法(CBT)可能是一种潜在的候选方法,可以通过系统评价和荟萃分析来明确。系统评价和荟萃分析中纳入研究的合格标准是使用 CBT 治疗脑卒中后抑郁的随机临床试验(RCT),或重点关注脑卒中后时期的生活质量或认知功能。在随机效应模型中,抑郁、生活质量和认知功能量表的终点评分是最终荟萃分析的靶向结果。共纳入了 10 项 RCT,共有 432 例脑卒中后患者接受 CBT 治疗,385 例患者接受对照组治疗。荟萃分析结果显示,CBT 可显著改善抑郁严重程度和生活质量。然而,在认知功能方面,CBT 组与对照组之间没有发现显著差异。此外,荟萃分析还存在显著的异质性。根据荟萃分析结果,CBT 可能有助于缓解抑郁严重程度和提高生活质量。然而,CBT 可能对认知功能没有影响。需要进一步开展设计更一致、样本量更大的研究,以明确和证实 CBT 对脑卒中后抑郁和生活质量的治疗效果。