Review of Interventions for Depression
What did the researchers aim to find out?
The aim was to analyse existing research on preventing and treating depression for people with aphasia after stroke.
Researchers asked three (3) questions:
Which interventions prevent and treat depression?
How are interventions changed to be easier or more accessible for people with communication difficulties to use?
Which interventions can be used for stepped care? (Stepped care is an approach to preventing and treating depression that divides care into 4 levels based on how severe depression is).
What type of research was done?
Systematic review.
Results of the research
Forty-five (45) studies were included in the review.
Stepped psychological care after stroke is a framework with levels 1 to 4 which can be used to prevent and treat depression for people with aphasia.
Level 1: For people with no clinically significant depression a range of rehabilitation interventions might help people with their mood (for example, goal setting and achievement, psychosocial support, communication partner training and narrative therapy).
Level 2: People with mild symptoms of depression may also benefit from existing interventions (for example, behavioural therapy, psychosocial support and problem solving).
Level 3 & 4: People with moderate to severe symptoms of depression require specialist mental health services that work together with stroke care.
Overall, there was a lack of information about strategies to change interventions to make them easier or more accessible for people with aphasia. Some studies did use communication supports (for example, simple language, pictures, rating scales).
It is not clear which interventions may prevent depression in post-stroke aphasia.
No evidence was found for the treatment of moderate to severe depression in post-stroke aphasia.
Almost half of studies about depression after stroke did not include people with aphasia. More research is needed because this is an important area of care.
Why was the research done?
The prevention and treatment of depression after stroke is important for people with aphasia. We want people with aphasia and their family members to receive the best possible care to improve their quality of life.
What does the research mean for me and others?
This research identified treatments that might help people with aphasia who have depression.
If you think you might have depression, please contact your GP for help or talk to another health professional in your stroke care team.
If you are seriously injured or know someone who is at risk of harm right now, call Triple Zero (000).
For help dealing with depression or suicidal thoughts, you can also call LifeLine at any time of day or night. Phone: 13 11 14
What research methods were used?
Systematic Review. Existing research in four research databases was searched and analysed.
How to obtain the treatment detailed in the research?
There were a range of treatments identified in the review that might help to improve mood for people with mild or no clinically significant depression.
If you think you might have depression, please contact your GP for help or talk to another health profession in your stroke care team.
If you are seriously injured or know someone who is at risk of harm right now, call Triple Zero (000).
For help dealing with depression or suicidal thoughts, you can also call LifeLine at any time of day or night. Phone: 13 11 14
Background information on the research topic
The prevention and treatment of depression after stroke is important for people with aphasia. We want people with aphasia and their family members to receive the best possible care to improve their quality of life. Approximately one third of people after stroke will have symptoms of depression at some time.
People with aphasia experience more severe, more persistent distress after stroke compared to people without aphasia after stroke. In acute stroke care, only 6% of people with mood problems get psychological assessment. In rehabilitation, only 32% of people get recommended psychological assessment and are offered counselling. There are not enough stroke care services that include psychology services (only 17–48%).
Risks related to the research
No risks.
Who was allowed to take part in the research?
There were no participants in this research. This was a review of already existing research.
Information about the people who took part
There were no participants in this research. This was a review of already existing research.
Why was the research done this way?
There are lots of different research studies looking at treating depression after stroke. But not all of these studies include people with aphasia. A review of the existing studies was needed to bring information together and work out the best ways of preventing and treating depression for people with aphasia after stroke.
When was the research done?
2017
Where was the research done?
This research was conducted from Australia, but it included a review of existing research from across the world.
Where did the money came from?
There was no funding for this research.
Problems with the research
No identified problems. But more research is needed.
Is the research trustworthy?
Yes. This research followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Next steps
This research showed there are not enough studies about preventing and treating moderate or severe depression that include people with aphasia. Better evidence for preventing and treating mild depression is also needed. More research is needed so that we can develop better treatments for people with aphasia who have depression. More training and support for health professionals to provide treatments for depression are also needed.
Where to find information related to the research?
For more information, contact Professor Linda Worrall. Email: l.worrall@uq.edu.au
