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Cited by 232Stroke Rehabilitation and RecoveryAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesCancer survivorship and care

Cognitive Behavioral Psychotherapy for Depression Following Stroke: A Randomized Controlled Trial

Lincoln, N.B., Flannaghan, T.·2003·Stroke
DOI 10.1161/01.str.0000044167.44670.55
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Abstract

Background and Purpose— There is inconclusive evidence of the effectiveness of psychological interventions for depression after stroke. We report the results from a randomized controlled trial of cognitive behavioral therapy (CBT). Methods— Stroke patients admitted to hospital were invited to complete mood questionnaires 1, 3 and 6 months after stroke. Patients who were depressed were invited to take part in a trial and randomly allocated to receive CBT (n=39), an attention placebo intervention (n= 43), or standard care (n=41). Outcome assessments were undertaken at 3 and 6 months after recruitment, on the Beck Depression Inventory, Wakefield Depression Inventory, Extended Activities of Daily Living scale, London Handicap Scale, and a rating of satisfaction with care. Results— There were no significant differences between the groups in patients’ mood, independence in instrumental activities of daily living, handicap, or satisfaction with care. Conclusions— CBT in the treatment of depression following stroke was found to be ineffective in this study. However, because of the small sample size, method of recruitment, and selection criteria, further randomized trials are required.

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  • Evidence for the efficacy of rehabilitation programs targeting cognition and mood separately remains mixed.

    “However, evidence for the efficacy of rehabilitation programs targeting cognition and mood separately remains mixed (Gertler et al., 2015;Lincoln & Flannaghan, 2003;Ponsford et al., 2016;Rogers et al., 2018).”

    From A single-case experimental evaluation of a new group-based intervention to enhance adjustment to life with acquired brain injury: VaLiANT (valued living after neurological trauma) (2022) · cites this paper as Lincoln & Flannaghan, 2003

    The Abstract describes evidence for psychological treatment of post-stroke depression as inconclusive, and this trial found no significant mood benefit from CBT. That supports the mood-treatment part of the claim, but the paper does not evaluate a separate cognition-focused rehabilitation program. (LLM, conf=0.85)

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  • An RCT found cognitive behavioural therapy to be ineffective with stroke survivors and reported that cognitive strategies were challenging for participants to implement.

    “A randomized controlled trial (RCT) found cognitive behavioural therapy (CBT) to be ineffective with stroke survivors and reported that cognitive strategies were challenging for participants to implement (Lincoln & Flannaghan, 2003).”

    From Brief group‐based acceptance and commitment therapy for stroke survivors. (2019) · cites this paper as Lincoln & Flannaghan, 2003

    The Abstract reports that this randomized trial found CBT ineffective for depression following stroke. The Discussion suggests that difficulty understanding or accepting the cognitive model could have contributed, but it does not report that participants found cognitive strategies challenging to implement. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Cognitive behavioural therapy is widely used for treating depression and anxiety, but there is no strong evidence for its post-stroke effectiveness, and research into its effectiveness following traumatic brain injury is inconclusive.

    “Cognitive behavioural therapy is widely used for treating depression and anxiety, but there is no strong evidence for its post-stroke effectiveness [10, 11], and research into its effectiveness following TBI is inconclusive [12–15].”

    From The BrainACT study: acceptance and commitment therapy for depressive and anxiety symptoms following acquired brain injury: study protocol for a randomized controlled trial. (2019) · cites this paper as [10]

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Cites

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Research works printed but not linked: 4

  1. Kemp BJ, Corgiat M, Gill C. Effects of brief cognitive behavioral group psychotherapy on older persons with and without disabling illness. Behav Health Ageing. 1992;2:21-28.
  2. Beck AT, Steer RA, Brown GK. Beck Depression Inventory Manual. 2nd ed. San Antonio, Texas: The Psychological Corporation; 1996:10.
  3. Fennel MJ. Depression. In. Hawton K, Salkovskis PM, Kirk J, Clark DM, eds. Cognitive Behaviour Therapy for Psychiatric Problems. Chapter 6. Oxford, UK: Oxford University Press; 1989:169 -234.
  4. Koder D-A, Brodaty H, Anstey KJ. Cognitive therapy for depression in the elderly. Int J Geriatr Psychiatry. 1996;11:97-107.

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Authors
Lincoln, N. B., & Flannaghan, T.
Affiliations
University of Nottingham (GB)
ORCID
Lincoln, N.B.
Venue
Stroke
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2003-01
Volume
34
Issue
1
Pages
111-115
ISSN
  • 0039-2499 (ISSN-L)
  • 1524-4628
DOI
10.1161/01.str.0000044167.44670.55
OpenAlex
W2163191988
Cited by
232
References
24
Citations by year
2026: 7 · 2025: 8 · 2024: 10 · 2023: 3 · 2022: 5 · 2021: 15 · 2020: 3 · 2019: 8 · 2018: 11 · 2017: 7 · 2016: 9 · 2015: 13 · 2014: 13 · 2013: 13 · 2012: 10
FWCI
7.65
Type
journal article
Language
en
Open access
closed
Locations
  • Stroke (publishedVersion)
  • PubMed (publishedVersion)
Funders
Stroke Association
Topics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
cognitive behavioral therapy, post-stroke depression, psychological intervention, depression treatment, activities of daily living, handicap, patient satisfaction, placebo comparison
MeSH terms
Aged, Depression, Female, Humans, Male, Cognitive Behavioral Therapy, Treatment Outcome, Stroke

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