Psychological interventions for preventing post-stroke depression
Krzysztof Pękala, Tomasz Sobów
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The aim of this article is to describe the available measures of preventing post-stroke depression and their efficacy with regard to psychological interventions. The said affective disorder is often poorly diagnosed for a number of reasons. Also the treatment itself turns sometimes to be inappropriate. It is worth highlighting that post-stroke depression affects the process of recovery of the patient, thus its harmful effect is not limited to a mere depressed mood. Studies describing the measures of prophylaxis of depression after stroke are dominated by those assessing the efficiency of pharmacotherapy. Meta-analyses point to a low efficiency of this type of therapeutic effects as well as to the inconsistency of their outcomes. Other methods of prevention efforts include those of psychological nature which should be divided into different categories, such as: psychotherapy, other unstructured interactions (for example: education, emotional and instrumental support, service of multidisciplinary team, physical exercises) or motivational interviewing. The results show that motivational interviewing is the most effective of all methods. Problem-solving therapy appears to be another effective intervention within the prevention of post-stroke depression. Also a short-term psychosocial-behavioral therapy produces good results. There is a definite and urgent need for more research on this subject that would enable the recommendation of an appropriate form of prophylaxis. The majority of the described studies are characterized by a small number of patients. It seems that different psychotherapeutic approaches that place the individual needs of the patient in the first place are worth further research. Those related to the behavioral approach seems to bring hope for greater efficacy.