Premium
Ecosystem focused therapy in poststroke depression: a preliminary study
Author(s) -
Alexopoulos George S.,
Wilkins Victoria M.,
Marino Patricia,
Kanellopoulos Dora,
Reding Michael,
Sirey Jo Anne,
Raue Patrick J.,
Ghosh Samiran,
O'Dell Michael W.,
Kiosses Dimitris N.
Publication year - 2012
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2822
Subject(s) - depression (economics) , ecosystem , psychology , psychiatry , medicine , ecology , biology , macroeconomics , economics
Objective Poststroke depression (PSD) occurs in the context of abrupt, often catastrophic disability that finds the patient and his or her family unprepared. We developed the Ecosystem Focused Therapy (EFT), a systematic intervention aimed to increase the PSD patient's and his or her ecosystem's abilities to address the “psychosocial storm” of PSD and utilize available treatments effectively and efficiently. This is a preliminary study of its efficacy. Design A total of 24 PSD patients were randomly assigned to receive weekly sessions of EFT or a comparison condition consisting of systematic Education on Stroke and Depression and their treatment for 12 weeks. Results Ecosystem Focused Therapy may be more efficacious than Education on Stroke and Depression in reducing depressive symptoms and signs, in leading to a higher remission rate, and in ameliorating disability in PSD. Reduction of disability in the early part of the trial mediated later improvement in depressive symptomatology. Similarly, reduction in depressive symptoms and signs early on mediated later improvement in disability. Conclusion These encouraging findings require replication. Beyond its potential direct benefits in PSD, EFT may provide an appropriate context for efficient and timely administration of pharmacotherapy and of physical, speech, and occupational therapy thus maximizing their efficacy. Copyright © 2012 John Wiley & Sons, Ltd.