Article

OBJECTIVE: To summarize empirical studies on the effectiveness of psychological
interventions in long-term rehabilitation after an acquired brain injury (ABI) in
reducing depressive symptoms. DATA SOURCES: A systematic literature search was
conducted on MEDLINE, PsycINFO, Embase, and CINAHL to identify articles published
between January 1990 and October 2011. Search terms included the 3 concepts (1)
"brain injur*" or "stroke," (2) "psychotherap*" or "therapy"
or "intervention" or
"rehabilitation," and (3) "depress*." STUDY SELECTION: Studies evaluating
psychological interventions in patients after ABI were included. Time since
injury was on average more than 1 year. Trials reported data on validated
depression questionnaires before and after the psychological intervention. DATA
EXTRACTION: Two independent reviewers extracted information from the sample, the
intervention, and the outcome of the included studies and calculated effect sizes
(ESs) from depression questionnaires. Thirteen studies were included in a
pre-post analysis. Seven studies were eligible for a meta-analysis of ESs in
active interventions and control conditions. DATA SYNTHESIS: Pre-post ESs were
significant in 4 of 13 studies. The overall ES of .69 (95% confidence interval
[CI], .29-1.09) suggests a medium effectiveness of psychological interventions on
depressive symptoms compared with control conditions. Moderator analysis of the
number of sessions and adequate randomization procedure did not show significant
ES differences between strata. Studies with adequate randomization did not,
however, suggest the effectiveness of psychological interventions on depressive
symptoms after ABI. CONCLUSIONS: Psychological interventions are a promising
treatment option for depressive symptoms in long-term rehabilitation after ABI.
Since only a few adequately randomized controlled trials (RCTs) exist, more RCTs
are required to confirm this initial finding.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS