Intervention Review

Interventions for preventing depression after stroke

  1. Maree L Hackett1,*,
  2. Craig S Anderson1,
  3. Allan House2,
  4. Christina Halteh3

Editorial Group: Cochrane Stroke Group

Published Online: 16 JUL 2008

Assessed as up-to-date: 2 MAR 2008

DOI: 10.1002/14651858.CD003689.pub3

How to Cite

Hackett ML, Anderson CS, House A, Halteh C. Interventions for preventing depression after stroke. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD003689. DOI: 10.1002/14651858.CD003689.pub3.

Author Information

  1. 1

    The George Institute for International Health, Department of Neurological and Mental Health, Sydney, NSW, Australia

  2. 2

    University of Leeds, Leeds Institute of Health Sciences, Leeds, UK

  3. 3

    University of Sydney, NHMRC Clinical Trials Research Centre, Camperdown, NSW, Australia

*Maree L Hackett, Department of Neurological and Mental Health, The George Institute for International Health, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.

Publication History

  1. Publication Status: New search for studies and content updated (conclusions changed)
  2. Published Online: 16 JUL 2008




  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak


Depression is an important consequence of stroke that impacts on recovery yet often is not detected or is inadequately treated.


To determine if pharmaceutical or psychological interventions can prevent depression and improve physical and psychological outcomes in patients with stroke.

Search methods

We searched the Trials Registers of the Cochrane Stroke Group (October 2007) and the Cochrane Depression Anxiety and Neurosis Group (February 2008). In addition, we searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2008), MEDLINE (1966 to May 2006), EMBASE (1980 to May 2006), CINAHL (1982 to May 2006), PsycINFO (1967 to May 2006), Applied Science and Technology Plus (1986 to May 2006), Arts and Humanities Index (1991 to September 2002), Biological Abstracts (1969 to September 2002), BIOSIS Previews (2002 to May 2006), General Science Plus (1994 to September 2002), Science Citation Index (1992 to May 2006), Social Sciences Citation Index (1991 to May 2006), SocioFile (1974 to May 2006) ISI Web of Science (2002 to February 2008), reference lists, trial registers, conference proceedings and dissertation abstracts, and contacted authors, researchers and pharmaceutical companies.

Selection criteria

Randomised controlled trials comparing pharmaceutical agents with placebo, or psychotherapy against standard care (or attention control) to prevent depression in patients with stroke.

Data collection and analysis

Two review authors independently selected trials, extracted data and assessed trial quality. Primary analyses were the proportion of patients who met the standard diagnostic criteria for depression applied in the trials at the end of follow up. Secondary outcomes included depression scores on standard scales, physical function, death, recurrent stroke and adverse effects.

Main results

Fourteen trials involving 1515 participants were included. Data were available for 10 pharmaceutical trials (12 comparisons) and four psychotherapy trials. The time from stroke to entry ranged from a few hours to seven months, but most patients were recruited within one month of acute stroke. The duration of treatment ranged from two weeks to one year. There was no clear effect of pharmacological therapy on the prevention of depression or other endpoints. A significant improvement in mood and the prevention of depression was evident for psychotherapy, but the treatment effects were small.

Authors' conclusions

A small but significant effect of psychotherapy on improving mood and preventing depression was identified. More evidence is required before recommendations can be made about the routine use of such treatments after stroke.


Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak

Interventions for preventing depression after stroke

The role of interventions for preventing depression after stroke is unclear. Depression is a common and important complication of stroke that is often missed or poorly managed. Little is known about whether treatment started early after stroke will reduce the risk of depression and improve recovery. This review of 14 trials, involving 1515 participants, found no evidence that antidepressant drugs prevent depression or improve physical recovery after stroke. Two trials showed that psychological therapy could improve patients' mood and prevent depression, but did not improve other outcomes. The generalisability of these findings to all stroke survivors is limited due to the small proportion of survivors who are eligible to participate in these clinical trials. More well-designed clinical trials are needed that test practical interventions for preventing depression across all stroke survivors.



  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak







Trials Registers of the Cochrane Stroke Group(2007年10月)およびCochrane Depression Anxiety and Neurosis Group(2008年2月)を検索した。これに加えて、Cochrane Central Register of Controlled Trials(コクラン・ライブラリ、2008年第1号)、MEDLINE(1966年~2006年5月)、EMBASE(1980年~2006年5月)、CINAHL(1982年~2006年5月)、PsycINFO(1967年~2006年5月)、Applied Science and Technology Plus(1986年~2006年5月)、Arts and Humanities Index(1991年~2002年9月)、Biological Abstracts(1969年~2002年9月)、BIOSIS Previews(2002年~2006年5月)、General Science Plus(1994年~2002年9月)、Science Citation Index(1992年~2006年5月)、Social Sciences Citation Index(1991年~2006年5月)、SocioFile(1974年~2006年5月)、ISI Web of Science(2002年~2008年2月)、参考文献リスト、試験登録、学会大会の予稿集、学位論文の抄録を検索し、著者、研究者および製薬企業に問い合わせた。










監  訳: 江川 賢一,2008.11.18

実施組織: 厚生労働省委託事業によりMindsが実施した。

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  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak







我們搜尋了Trials Registers of the Cochrane Stroke Group (2007年10月) 以及Cochrane Depression Anxiety and Neurosis Group (2008年2月)。此外,我們搜尋了Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2008)、MEDLINE(1966年至2006年5月)、EMBASE(1980年至2006年5月)、CINAHL(1982年至2006年5月)、 PsycINFO(1967年至2006年5月)、Applied Science and Technology Plus (1986年至2006年5月) 、 Arts and Humanities Index(1991年至2002年9月)、Biological Abstracts (1969年至2002年9月)、 BIOSIS Previews(2002年至2006年5月)、General Science Plus (1994年至2002年9月) 、 Science Citation Index (1992年至2006年5月)、 Social Sciences Citation Index (1991年至2006年5月)、 SocioFile (1974年至2006年5月)、 ISI Web of Science(2002年至2008年2月)、參考文獻目錄、試驗登錄、會議記錄和論文摘要、並與作者、研究人員、以及製藥公司取得聯繫。











此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。,




Laički sažetak

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak

Intervencije za sprječavanje depresije nakon moždanog udara

Uloga intervencija za sprječavanje depresije nakon moždanih udara nije jasna. Depresija je česta i važna posljedica moždanog udara, koja se često zanemaruje ili loše liječi. Malo se zna o tome hoće li terapija koja započne rano nakon moždanog udara smanjiti rizik od depresije i poboljšati oporavak. Ovaj Cochrane sustavni pregled uključio je 14 studija i 1515 ispitanika. Nisu pronađeni dokazi da antidepresivi sprječavaju depresiju ili poboljšavaju fizički oporavak nakon moždanog udara. Dva ispitivanja su pokazala da psihološka terapija možda može poboljšati raspoloženje pacijenata i spriječiti depresiju, ali nije poboljšala druge ishode. Ti rezultati se ne mogu primijeniti na sve pacijente koji su preživjeli moždani udar zbog malog udjela preživjelih koji mogu sudjelovati u ovakvim kliničkim ispitivanjima. Potrebno je više dobro osmišljenih kliničkih ispitivanja za testiranje praktičnih intervencija za sprječavanje depresije u svih preživjelih nakon moždanog udara.

Bilješke prijevoda

Hrvatski Cochrane
Prevela: Livia Puljak
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