Published online before print February 15, 2007, doi: 10.1161/01.STR.0000257320.08660.97
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(Stroke. 2007;38:850.)
© 2007 American Heart Association, Inc.
Editorials |
Care Management for Poststroke Depression
From the Division of Rehabilitation & Ageing, University of Nottingham, Queens Medical Centre, Nottingham, United Kingdom.
Correspondence to Shirley A. Thomas, PhD, Division of Rehabilitation & Ageing, University of Nottingham, B Floor Medical School, Queens Medical Centre, Nottingham, United Kingdom NG7 2UH. E-mail shirley.thomas@nottingham.ac.uk
Key Words: depression • psych & behavior • randomized controlled trials • rehabilitation
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
See related article, pages 998–1003.
Depression is a common consequence of stroke, occurring in one third of people at some point after stroke.1 It is important that depression is viewed as more than an understandable consequence of a sudden-onset major life event, because depression after stroke is associated with poorer rehabilitation outcome,2,3 lower quality of life,4 and suicide.5 Yet few people receive effective management for depression after stroke.1
Cochrane reviews have reported that there is not sufficient evidence for the benefit of pharmacological or psychologic treatments to prevent6 or treat7 depression after stroke. Few adequately powered randomized, controlled trials of interventions for poststroke depression have been conducted. Therefore, the study by Williams et al8 in the current issue of Stroke is a welcome addition to the literature on this important topic.
Williams et al report the findings of a well-designed randomized, controlled trial evaluating a care management program for poststroke depression in 188 people with major or minor depression between 1 and 2 months after ischemic stroke. Depression response and remission were significantly more likely at the 12-week assessment point in those participants who were randomized to receive the Activate–Initiate–Monitor (AIM) program than those who received usual care.
A description of the AIM intervention can be found in the article by Williams et al. An important feature of the intervention is that it is an active approach to managing depression. The participants received education to make them aware of the symptoms and treatment of their depression. Also, the choice
Related Article:
Stroke 2007 38: 998-1003.