Psychological Intervention Poststroke

Abstract

See related article, pages 3073–3078. Stroke is distressing and frequently affects mood and behavior.1 The negative impact of mood and adjustment disorders on physical recovery and reintegration is recognized2–4 and makes it even more imperative that early effective interventions are established. However, there has been a failure to respond to this distress at an early stage after stroke, perhaps due to staff viewing distress as an inevitable psychological reaction to a debilitating event or due to a lack of clear guidance around prevention and treatment of mood problems. Later on in the recovery process when this distress has become established as a mood disorder, there has been a failure to react, and care remains suboptimal. The lack of robust evidence to guide treatment is a major contributing factor. Thus far, the results of antidepressant studies in those with established depression have been disappointing with short-term gains not being …