Cited by 177Stroke Rehabilitation and RecoveryTreatment of Major DepressionCancer survivorship and care

Brief Psychosocial–Behavioral Intervention With Antidepressant Reduces Poststroke Depression Significantly More Than Usual Care With Antidepressant: Living Well With Stroke: Randomized, Controlled Trial

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Mitchell, Pamela H., Veith, Richard C., Becker, Kyra J., Buzaitis, Ann, Cain, Kevin C., Fruin, Michael, Tirschwell, David, Teri, Linda·2009·Stroke

Abstract

Background and Purpose— Depression after stroke is prevalent, diminishing recovery and quality of life. Brief behavioral intervention, adjunctive to antidepressant therapy, has not been well evaluated for long-term efficacy in those with poststroke depression. Methods— One hundred one clinically depressed patients with ischemic stroke within 4 months of index stroke were randomly assigned to an 8-week brief psychosocial–behavioral intervention plus antidepressant or usual care, including antidepressant. The primary end point was reduction in depressive symptom severity at 12 months after entry. Results— Hamilton Rating Scale for Depression raw score in the intervention group was significantly lower immediately posttreatment ( P <0.001) and at 12 months ( P =0.05) compared with control subjects. Remission (Hamilton Rating Scale for Depression <10) was significantly greater immediately posttreatment and at 12 months in the intervention group compared with the usual care control. The mean percent decrease (47%±26% intervention versus 32%±36% control, P =0.02) and the mean absolute decrease (−9.2±5.7 intervention versus −6.2±6.4 control, P =0.023) in Hamilton Rating Scale for Depression at 12 months were clinically important and statistically significant in the intervention group compared with control. Conclusion— A brief psychosocial–behavioral intervention is highly effective in reducing depression in both the short and long term.

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Registry

Crossref · 10.1161/strokeaha.109.549808

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  • In one included study, adverse effects were said to be monitored.

    “In one study, adverse effects were said to be monitored (see Mitchell 2008 under Mitchell 2009).”

    From Behavioural activation therapy for depression in adults with non-communicable diseases (2020) · cites this paper as Mitchell 2008 under Mitchell 2009

    The Discussion (page unavailable) says that the separate AIM trial monitored medication side effects by telephone. The Methods describe medication diaries and follow-up for Mitchell’s own Living Well with Stroke trial, but do not say that adverse effects were monitored in that trial, which the parenthetical appears to identify. (LLM, conf=0.82)

    Experimental — accuracy not yet measured
  • Participants in the study by Mitchell and colleagues had a mix of gender, age, and ethnicity.

    “Participants in the study by Mitchell and colleagues had a mix of gender, age, and ethnicity (Mitchell 2009), while participants in the study by Hopko and colleagues were all women, with a mean age of 55 years, and mostly White American (Hopko 2011).”

    From Behavioural activation therapy for depression in adults with non-communicable diseases (2020) · cites this paper as Mitchell 2009

    The Results section reports that participants were 59% male and ranged in age from 25 to 88 years, supporting a mix of gender and age. The passages in our copy do not establish a mix of ethnicities; searches for ethnicity and race did not find a participant breakdown. No page number is available in the indexed copy. (LLM, conf=0.85)

    Experimental — accuracy not yet measured
  • One study used a mental health specialist to deliver the intervention (Mitchell 2009).

    “One study used a mental health specialist to deliver the intervention (Mitchell 2009), while the other used clinical psychology doctoral students (specialists in training) (Hopko 2011).”

    From Behavioural activation therapy for depression in adults with non-communicable diseases (2020) · cites this paper as Mitchell 2009

    The Methods > Design section describes the intervention as nurse-delivered, and Methods > Study Protocol says participants met with a study interventionist nine times. Our copy does not identify that nurse or interventionist as a mental health specialist, so it supports who delivered the intervention only at a less specific level. (LLM, conf=0.84)

    Experimental — accuracy not yet measured
  • Treatment as usual in this case primarily involved the provision of medical care after stroke.

    “Treatment as usual in this case primarily involved the provision of medical care after stroke.”
  • One study compared behavioural activation with an antidepressant (sertraline in the first instance) versus treatment as usual with an antidepressant (Mitchell 2009).

    “One study compared behavioural activation with an antidepressant (sertraline in the first instance) versus treatment as usual with an antidepressant (Mitchell 2009).”

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Authors
Mitchell, P. H., Veith, R. C., Becker, K. J., Buzaitis, A., Cain, K. C., Fruin, M., Tirschwell, D., & Teri, L.
Affiliations
University of Washington (US)
Venue
Stroke
Published
2009-09
Volume
40
Issue
9
Pages
3073-3078
ISSN
  • 0039-2499 (ISSN-L)
  • 1524-4628
OpenAlex
W2040664278
Cited by
177
References
38
Citations by year
2026: 8 · 2025: 4 · 2024: 14 · 2023: 12 · 2022: 4 · 2021: 6 · 2020: 15 · 2019: 15 · 2018: 8 · 2017: 18 · 2016: 4 · 2015: 11 · 2014: 14 · 2013: 10 · 2012: 8
FWCI
10.87
Type
journal article
Language
en
Open access
Locations
  • Stroke (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Nursing Research (R01NR007755)
Topics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
post-stroke depression, ischemic stroke, antidepressants, adjunctive psychotherapy, depression severity, remission, long-term efficacy, stroke rehabilitation
MeSH terms
Adult, Aged, Aged, 80 and over, Antidepressive Agents, Depression, Female, Humans, Male, Middle Aged, Quality of Life, Time Factors, Stroke

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