Why the fuck are you working on this secondary problem when the correct course of action is to prevent it from happening by having EXACT 100% RECOVERY PROTOCOLS?
Are you that blitheringly stupid along with your mentors and senior researchers that approved this crapola?
Send me hate mail on this: oc1dean@gmail.com. I'll print your complete statement with name and my response in my blog. Or are you afraid to engage with my stroke-addled mind?
The latest here:
Effect of nonpharmacological interventions on poststroke depression: a network meta-analysis
Ying Li
Yuanyuan Wang2†
Lei Gao
Qidan Deng- 1College of Sports Science, Jishou University, Jishou, China
- 2Cardiac Care Unit, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
- 3School of Nursing, Dalian University, Dalian, China
- 4Department of Intensive Care Unit, Affiliated Qingyuan Hospital, Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, China
Purpose: To investigate the effects of nonpharmacological interventions (NPIs) on poststroke depression (PSD) in stroke patients.
Methods: Computer searches were conducted on the PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang databases from their establishment to December 2023. The selection was made using the inclusion and exclusion criteria, and 40 articles were included to compare the effects of the 17 NPIs on patients with PSD.
Results: Forty studies involving seventeen interventions were included. The network findings indicated that compared with conventional therapy (COT), superior PSD improvement was observed for cognitive behavioral therapy (CBT) + acupoint acupuncture (CBTA) (mean difference [MD], −4.25; 95% CI, −5.85 to −2.65), team positive psychotherapy (MD, −4.05; 95% CI, −5.53 to −2.58), music therapy (MT) + positive psychological intervention (MD, −2.25; 95% CI, −3.65 to −0.85), CBT (MD, −1.52; 95% CI, −2.05 to −0.99), mindfulness-based stress reduction (MD, −1.14; 95% CI, −2.14 to −0.14), MT (MD, −0.95; 95% CI, −1.39 to −0.52), acupoint acupuncture + MT (AAMT) (MD, −0.69; 95% CI, −1.25 to −0.14). Furthermore, CBT (MD, −3.87; 95% CI, −4.57 to −3.17), AAMT (MD, −1.02; 95% CI, −1.41 to −0.62), acupressure + MT (MD, −0.91; 95% CI, −1.27 to −0.54), and narrative care + acupressure (MD, −0.74; 95% CI, −1.19 to −0.29) demonstrated superior Pittsburgh Sleep Quality Index (PSQI) improvement compared with COT.
Conclusion: Evidence from systematic reviews and meta-analyses suggests that CBTA improves depression in patients with PSD. Moreover, CBT improves sleep in these patients. Additional randomized controlled trials are required to further investigate the efficacy and mechanisms of these interventions.
Introduction
According to the World Health Organization (WHO) statistics in 2019, stroke is the second leading cause of death, accounting for approximately 11% of total deaths (1). Stroke has a serious impact on multiple functional domains and often leads to disability, affecting patients’ quality of life and leading to negative emotional states (2). Stroke survivors may face significant health challenges and are more likely to experience psychological disorders owing to their severe symptoms and physical disabilities. Depression is one of the most common complications of stroke, with a prevalence rate of 30–33% (3–6). The core symptom cluster includes feelings of low mood, emotional detachment, fatigue, insomnia, feelings of worthlessness, and even suicidal ideation (7–10). Poststroke depression (PSD) negatively affects physical, cognitive, and functional recovery; increases the risk of recurrent vascular events; reduces quality of life; decreases social participation; and increases mortality rates (11, 12). Therefore, it is of utmost importance to identify safe and effective treatment approaches for PSD (13). However, the effectiveness of pharmacological interventions in PSD remains unclear. Furthermore, the use of medications may be further limited by adverse effects, long reaction times, potential drug-related events, and low compliance (14–16). For these reasons, alternative or complementary choices for medication selection are critical to ensure effective management of PSD (17). Nonpharmacological interventions (NPIs) are scientifically based, noninvasive measures for human health that may offer an alternative approach to improving depressive symptoms (17).
A substantial body of evidence supports the effectiveness of NPIs for depression in various clinical populations (15, 18). Several reviews have identified and qualitatively provided evidence for the use of NPIs in PSD (14, 18, 19). In particular, a review suggested that therapeutic approaches such as problem-solving therapy, acupuncture, music therapy (MT), exercise therapy, and motivational interviewing can alleviate depressive symptoms (14). However, evidence-based recommendations regarding the most effective NPIs for improving PSD are currently lacking. Therefore, it is crucial to identify appropriate NPIs that can effectively reduce PSD. Network meta-analysis (NMA), also known as a meta-analysis of mixed or multiple treatment comparisons (20), compares the impact of various NPIs on PSD by estimating both direct and indirect comparisons. Although a previously published NMA has been identified, it only reported the effects of pharmacological treatments and did not investigate NPIs further (21). Hence, the objective of this study was to conduct an NMA of relevant randomized controlled trials (RCTs) to compare the effects of different NPIs on PSD. The results of this study are essential for formulating clinical practice guidelines and recommending optimal intervention strategies to improve PSD.
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