Talking therapies can be an effective treatment for stroke survivors, especially if started within six months, finds new research from UCL.
Published in Nature Mental Health, the study found nearly three-quarters (71%) of stroke survivors with depression or anxiety saw ‘a reliable improvement’ in their symptoms and 49% ‘reliably recovered’ following treatment.
More than one in three stroke survivors experience depression or anxiety and, without appropriate mental health treatment, recovery – both physical and cognitive – can be slower. Previous studies have shown that the risk of death may increase by 20-50% in the years following a stroke in those with depression compared to those without.
For the paper Effectiveness of primary care psychological therapy post-stroke: a record-linkage study of 1.9 million adults in England, UCL researchers analysed data from 1.9 million patients who attended NHS Talking Therapies for Anxiety and Depression services in England between 2012 and 2019, including 7,597 stroke survivors.
On average, stroke survivors who attended talking therapies experienced a moderate reduction in depression and functional impairment symptoms – such as the ability to work, manage a home, form and maintain close relationships, and partake in leisure activities – and significant reductions in anxiety symptoms.
The timing of access to talking therapy after a stroke was found to impact its effectiveness, according to the study.
Patients who started attending talking therapies a year or more after a stroke were less likely to reliably recover than those seen within six months of a stroke. This was regardless of differences in characteristics such as age, gender, area deprivation, and baseline symptom scores.
Lead author Dr Jae Won Suh from UCL Psychology & Language Sciences said that ‘the sooner stroke survivors begin talking therapy, the better the outcomes’.
She said: ‘It is essential for general practitioners and other clinicians working with stroke survivors to screen for depression and anxiety symptoms and refer patients for psychological therapy as early as possible.’
However, the researchers believe talking therapies may need to be adapted to ensure maximum impact for stroke survivors.
The study found that stroke survivors who had talking therapy were less likely to reliably recover and more likely to reliably deteriorate when compared to otherwise similar people who had not had a stroke.
Co-author UCL Professor Joshua Stott explained: ‘The worse outcomes for stroke survivors compared to those who had not had a stroke suggest the importance of mental health clinicians receiving more training on treating people with long-term conditions, including those with cognitive impairments, sensory loss, and complex physical health issues.’
He added: ‘Investing in such training will improve both mental and physical health outcomes for thousands of patients.’
The research was funded by the Alzheimer’s Society.
