Table 8.4 Psychotherapy for the Treatment of Depression Post ABI
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Author Year Country Research Design PEDro Sample Size |
Methods |
Outcomes |
|
Brenner et al. (2017) United States RCT PEDro=6 NInitial=44 NFinal=35 |
Population: TBI; Gender: Male=32, Female=2, Transgender=1. Experimental Group (n=15): Mean Age=47.7yr Control Group (n=20): Mean Age=54.6yr. Intervention: Participants were randomized to receive a manualized, small-group cognitive behavioural intervention focused on alleviating hopelessness or to a waitlist. The intervention was 2hr and delivered weekly for 10 wk. Participants were crossed over to the alternate intervention after 10wk. Assessments occurred at baseline, 10wk, and 20wk. Outcome Measure: Beck Hopelessness Scale (BHS), Beck Depression Inventory (BDI), Beck Scale for Suicide Ideation (BSSI). | 1. After controlling for baseline BHS scores, the intervention group had significantly lower hopelessness post intervention compared to those on the waitlist (p=0.03); these reductions were maintained at follow-up. 2. The waitlist group demonstrated significant reductions on the BHS (p=0.01) and depression (p=0.003) after completing the intervention. 3. There were no significant between-group differences for the BDI or BSSI. |
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Andrewes et al. (2014) UK RCT Pedro=5 NInitial=10 NFinal=9 |
Population: TBI; Mean Age=42.2yr; Gender: Male=9, Female=1; Mean Time Post Injury=4.8yr. Intervention: In-patients being treated for substance mis-use and challenging behavior were randomized to 12wk Positive Psychology group (intervention group) or control. Positive Psychology consisted of “Three Good Things” and “Signature Strengths” interventions. Outcome Measure: Seligman’s Authentic Happiness Index (AHI), Head Injury Semantic Differential Scale (HISDS), The Hospital Anxiety and Depression Scale and Brief Strengths Test. | 1. After the “three good things” intervention, the intervention group scored significantly higher on the AHI measurement of happiness than the control group (p=0.02). 2. No significant between group differences for the AHI scores from pre-test compared to at the end of the 12wk program. 3. No significant between group or pre-post intervention differences were found for HISDS scores. |
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Holleman et al. (2018) Netherlands PCT N=75 |
Population: TBI=33, Stroke=14, Other=28; Gender: Male=47, Female=28. Experimental Group (n=42): Mean Age=43.3yr; Mean Time Post Injury=7.9yr. Control Group (n=33): Mean Age=40.7yr; Mean Time Post Injury=6.9yr. Intervention: Participants received Intensive NeuroRehabilitation programme (INR; 16wk, with 2wk break) or were placed in a waitlist control group (WC). The INR sessions focused on orientation, cognitive training, relaxation and physical activities, and group discussion to help patients cope with cognitive, emotional and behavioral changes. Outcome measures for the experimental group were evaluated pre and post-INR. Control group baseline was 15 weeks prior to their INR start date and follow-up at their start date. Outcome Measure: Dutch Symptom Check-list-90 (SCL-90), Beck Depression Inventory II (BDI-II), Hospital Anxiety Depression Scale (HADS), Quality of Life in Brain Injury questionnaire (QOLIBRI), and neuropsychological tests. | 1. The INR treatment group had significantly greater mean change from baseline compared to the WC group for psychological well-being (p<0.001), Depression (p<0.001), Anxiety (p<0.001), and Quality of Life (p=0.001). 2. At follow-up, the INR group scored significantly better than WC for psychological well-being (SCL-90, p=0.005), depression (BDI-II, p=0.001; HADS, p=0.009), anxiety (HADS, p=0.003), and quality of life (QOLIBRI, p=0.008). 3. There were no significant between group differences at baseline or follow-up for neuropsychological tests scores. |
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Wiart et al. (2012) France Case Series N= 47 |
Population: TBI; Mean Age=33.4yr; Gender: Male=35, Female=12; Mean Time Post Injury=11.1yr. Intervention: Retrospective review of patients with mood disorders referred to a single physician for at least 1yr of neuro-systemic psychotherapy. Outcome Measure: Diagnostic and Statistical Manual of Mental Disorders (DSM), Glasgow Outcome Scale. | 1. Significant improvement of affective disorders was found: depression (p<0.001), anxiety (p<0.001), and hostility (p<0.01). 2. No improvements were seen in apathy, bipolar symptomatology, loss of control, or addictive disorders. 3. GOS classification was 50% as very good or good, 21% average, and 27% poor. |