Psychological adjustment after stroke

The systematic review critically evaluates and synthesises the available literature on the effectiveness of psychotherapeutic interventions targeted at reducing depressive symptomatology following stroke. Studies were identified through electronic database searches using terms related to ‘stroke’, ‘patient’, ‘depression’, ‘intervention’, and ‘trial.’ Thirteen studies were included in the review. The large amount of heterogeneity between the reviewed studies precluded the use of meta-analysis. Nonetheless, the findings support the use of psychotherapy for treatment of post-stroke depression, with behaviour therapy demonstrating beneficial effects. The methodological limitations of the reviewed studies and recommendations for clinical practice and future research are discussed.

The research study investigated relationships between mindfulness, coping and psychological outcomes in a stroke population. Using a cross-sectional design, participants (N = 114) completed The Five Facet Mindfulness Questionnaire, The Brief Ways of Coping Questionnaire, The Mental Adjustment to Stroke Scale, The Patient Health Questionnaire-9 and The General Anxiety Disorder Questionnaire-7. Mindfulness explained significant amounts of variance in psychological adjustment to stroke and post-stroke depression and anxiety. Dysfunctional coping was found to mediate the effect of the mindfulness facet ‘acting with awareness’ on the adjustment subscale ‘helplessness/hopelessness.’ This study provides support for the role of mindfulness and coping in recovery following stroke. The clinical implications of these findings are discussed in addition to future research recommendations.