Cognitive Behavioural Therapy for Managing Depressive and Anxiety Symptoms After Stroke: A Systematic Review and Meta-Analysis

Objective(s) To evaluate the efficacy of cognitive behavioural therapy on anxiety and depression among the stroke population. Data Sources Medline, PsycInfo and EMBR Cochrane were used to locate studies published between 1990 and May 2020. Study Selection Two blind reviewers included articles with the following criteria: (1) primary trials involved a CBT based intervention, (2) participants experienced a stroke at least three months previous, (3) participants were at least 18, and (4) the primary effect of the CBT were anxiety and/or depression. 10 articles were included in the final meta-analysis; 6 of these were randomized controlled trials and 4 were pre-post design. Data Extraction Two independent reviewers extracted: author, study design, sample size, age, sex, time since injury, inclusion criteria, exclusion criteria, treatment provided, comparator, primary outcome measures, time of follow up, dropout rates, concomitant treatments, and adverse effects. Cochrane Risk of Bias tool was used. Data Synthesis Pooled analysis was conducted on depression and anxiety. Cohen's d was used. CBT interventions showed large effects on reducing anxiety (SMD±SE: 1.01±0.32, p Conclusions Found that CBT was effective in reducing symptoms of depression and anxiety post stroke in the chronic phase. A sub-analysis found that group-based interventions had similar effect size as individual-based CBT interventions. Additionally, our analysis found that a relatively brief 8-week interventions may be more effective than long-term programs. Examination of long-term effects and satisfaction with treatment are recommended topics for future research. Author(s) Disclosures No conflicts.