. Determinants of the Natural Course of Depressive Symptoms in Stroke Survivors in the Netherlands: The SMART-Medea Study

Objective: Mindfulness- and acceptance-based intervention (MABI) is an emerging evidenced-based practice, but no systematic review incorporating meta-analyses for MABIs in stroke survivors has been conducted. The objective of this systematic review was to measure the effectiveness of MABIs on outcomes in people with stroke. Method: Three electronic databases, including PubMed, CINAHL, and PsycINFO, were searched to identify relevant studies published in peer-reviewed journals. The methodological quality of the included studies was assessed. Data were extracted and combined in a meta-analysis with a random-effect model to compute the size of the intervention effect. Results: A total of 11 studies met the eligibility criteria. Meta-analyses found a small-to-moderate effect of MABIs on depressive symptoms (standardized mean difference [SMD] = 0.39, 95% confidence interval [CI] = [0.12, 0.66]) and a large effect on mental fatigue (SMD = 1.22, 95% CI = [0.57, 1.87]). No statistically significant effect of MABIs on anxiety, quality of life, and mindfulness was found, but there was a trend in favor of MABIs overall. Conclusions: This meta-analysis found positive effects of MABIs on depressive symptoms and mental fatigue in stroke survivors, but future high-quality studies are needed to guarantee treatment effects of MABIs on varied outcomes in stroke survivors.

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Abstract WP409: Heterogeneous Patterns of Depressive Symptoms Among Stroke Survivors: Implications for Screening

Stroke ◽

10.1161/str.50.suppl_1.wp409 ◽

2019 ◽

Vol 50 (Suppl_1) ◽

Author(s):

Liming Dong ◽

Lesli Skolarus ◽

Lewis Morgenstern ◽

Lynda Lisabeth

Keyword(s):

Depressive Symptoms ◽

Stroke Survivors

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Guided internet-based intervention for people with HIV and depressive symptoms: a randomised controlled trial in the Netherlands

The Lancet HIV ◽

10.1016/s2352-3018(18)30133-4 ◽

2018 ◽

Vol 5 (9) ◽

pp. e488-e497 ◽

Cited By ~ 13

Author(s):

Sanne van Luenen ◽

Nadia Garnefski ◽

Philip Spinhoven ◽

Vivian Kraaij

Keyword(s):

Depressive Symptoms ◽

Randomised Controlled Trial ◽

The Netherlands ◽

Controlled Trial ◽

Randomised Controlled ◽

Internet Based Intervention

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Associations between characteristics of stroke survivors and caregiver depressive symptoms: a critical review

Topics in Stroke Rehabilitation ◽

10.1080/10749357.2019.1641010 ◽

2019 ◽

Vol 26 (7) ◽

pp. 528-537 ◽

Cited By ~ 3

Author(s):

Meghan T. Hultman ◽

Susan A. Everson-Rose ◽

Mary Fran Tracy ◽

Ruth Lindquist ◽

Niloufar Niakosari Hadidi

Keyword(s):

Depressive Symptoms ◽

Critical Review ◽

Stroke Survivors

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An analysis of depressive symptoms in stroke survivors: verification of a moderating effect of demographic characteristics

BMC Psychiatry ◽

10.1186/s12888-017-1292-4 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 9

Author(s):

Eun-Young Park ◽

Jung-Hee Kim

Keyword(s):

Depressive Symptoms ◽

Demographic Characteristics ◽

Moderating Effect ◽

Stroke Survivors

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Collaborative care for patients with bipolar disorder: randomised controlled trial

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.152520 ◽

2015 ◽

Vol 206 (5) ◽

pp. 393-400 ◽

Cited By ~ 13

Author(s):

Trijntje Y. G. van der Voort ◽

Berno van Meijel ◽

Peter J. J. Goossens ◽

Adriaan W. Hoogendoorn ◽

Stasja Draisma ◽

...

Keyword(s):

Mental Health ◽

Bipolar Disorder ◽

Depressive Symptoms ◽

Medication Adherence ◽

The Netherlands ◽

Collaborative Care ◽

Controlled Trial ◽

Response To Treatment ◽

Care Programme ◽

Relevant Effect

BackgroundA substantial number of people with bipolar disorder show a suboptimal response to treatment.AimsTo study the effectiveness of a collaborative care programme on symptoms and medication adherence in patients with bipolar disorder, compared with care as usual.MethodA two-armed, cluster randomised clinical trial was carried out in 16 out-patient mental health clinics in The Netherlands, in which 138 patients were randomised. Patient outcomes included duration and severity of symptoms and medication adherence, and were measured at baseline, 6 months and 12 months. Collaborative care comprised contracting, psychoeducation, problem-solving treatment, systematic relapse prevention and monitoring of outcomes. Mental health nurses functioned as care managers in this programme. The trial was registered with The Netherlands Trial Registry (NTR2600).ResultsCollaborative care had a significant and clinically relevant effect on number of months with depressive symptoms, both at 6 months (z =–2.6, P = 0.01, d = 0.5) and at 12 months (z =–3.1, P = 0.002, d = 0.7), as well as on severity of depressive symptoms at 12 months (z =–2.9, P = 0.004, d = 0.4). There was no effect on symptoms of mania or on treatment adherence.ConclusionsWhen compared with treatment as usual, collaborative care substantially reduced the time participants with bipolar disorder experienced depressive symptoms. Also, depressive symptom severity decreased significantly. As persistent depressive symptoms are difficult to treat and contribute to both disability and impaired quality of life in bipolar disorder, collaborative care may be an important form of treatment for people with this disorder.

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Depressive Symptoms and Diurnal Salivary Cortisol Patterns Among Female Caregivers of Stroke Survivors

Biological Research For Nursing ◽

10.1177/1099800412439458 ◽

2012 ◽

Vol 14 (4) ◽

pp. 396-404 ◽

Cited By ~ 15

Author(s):

Karen L. Saban ◽

Herbert L. Mathews ◽

Fred B. Bryant ◽

Timothy E. O’Brien ◽

Linda Witek Janusek

Keyword(s):

Depressive Symptoms ◽

Chronic Stress ◽

Caregiver Burden ◽

Perceived Stress ◽

Salivary Cortisol ◽

Allostatic Load ◽

Depression Scale ◽

Epidemiologic Studies ◽

Stroke Survivors ◽

Increased Risk

Informal caregivers of stroke survivors experience elevated chronic stress and are at risk of developing depressive symptoms. The cumulative effects of chronic stress can increase allostatic load and dysregulate biological processes, thus increasing risk of stress-related disease. Stress-induced alterations in the pattern of cortisol secretion vary with respect to stressor onset, intensity, and chronicity. Little is known about the psychoendocrine response to stress in female caregivers of stroke survivors. The purpose of this study was to examine perceived stress, caregiver burden, and the association between caregiver depressive symptoms and diurnal cortisol in 45 females caring for a significant other who experienced a stroke within the past year. Women completed the Center for Epidemiologic Studies Depression Scale (CES-D) and collected saliva for cortisol upon awakening, 30 min postawakening, noon, and bedtime for 2 consecutive days. Results revealed that women had high levels of perceived stress and caregiver burden. In women with CES-D scores ≥ 16, salivary cortisol levels were significantly lower across the day relative to women with CES-D scores < 16. This difference persisted after adjusting for age, number of caregiving hours per week, perceived social support, and quality of sleep. Younger age was associated with more depressive symptoms as well as lower levels of cortisol at awakening and 30 min postawakening. Results demonstrate that the burden of caregiving increases risk of depressive symptoms and hypocortisolism across the day. Hypocortisolism may contribute to increased risk of depressive symptoms as a result of the loss of glucocorticoid attenuation of stress-induced inflammation.

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