Impact of Rational Emotive Behavior Therapy on Sleep and Mood in Patients with Post-stroke Depression

Abstract

Background Depression is a common mood disorder that seriously affects the recovery of various functions in patients after stroke. Antidepressant drug therapy alone could not achieve satisfactory treatment responses. Objective To investigate the effects of rational emotive behavior therapy (REBT) on sleep and mood in patients with post-stroke depression. Methods Seventy-one patients with post-stroke depression were selected from Department of Neurological Rehabilitation, the Second Affiliated Hospital of Zhengzhou University from June 2019 to June 2020, and according to random number table, they were divided into the control group (n=35) or combined treatment group (n=36) . The control group received four consecutive weeks of treatment with oral sertraline hydrochloride tablets (25 mg per day within the first week, and 50 mg per day within other three weeks) . The combined treatment group received four consecutive weeks of treatment with REBT (three times per week, the treatment duration for each time lasting for 30 minutes) plus the same treatment for the control group. Pittsburgh Sleep Quality Index (PSQI) , Insomnia Severity Index (ISI) , 17-item Hamilton Depression Rating Scale (HAMD-17) , Hamilton Anxiety Rating Scale (HAMA) , and Modified Barthel Index (MBI) were used to assess pre- and post-treatment sleep quality, insomnia severity, depression prevalence, anxiety prevalence and ability to engage in basic activities of daily living, respectively. Results The mean scores of PSQI, ISI, HAMD-17, and HAMA showed a significant decrease and the mean score of MBI demonstrated a significant increase in both groups after treatment (P<0.05) . The mean post-treatment scores for PSQI and HAMA demonstrated no significant differences between two groups (P>0.05) . The combined treatment group had lower mean post-treatment scores of ISI and HAMD-17 and higher mean post-treatment score of MBI than the control group (P<0.05) . The improvement in depression was much better in the combined treatment group (P<0.05) . The improvement in anxiety was more obviously in the combined treatment group (P<0.05) . Conclusion REBT plus oral sertraline hydrochloride tablets could produce better effects on improving insomnia, mood, and ability to engage in basic activities of daily living in patients with post-stroke depression.

Keywords

• depression|stroke|rational emotive behavior therapy|post-stroke depression|sleep|emotions|treatment outcome