Interventions for Mood Disorders after Stroke

Poh, Jade (2020) Interventions for Mood Disorders after Stroke. Doctoral thesis, University of East Anglia.

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Background: In recent years, there have been many advancements in clinical research and rehabilitation of stroke. However, current gaps in the literature remains as it is yet to draw conclusions on the best available tools for measuring health-related quality of life (HR-QOL), and the best evidenced interventions for post-stroke mood disorders.

Aim: This research portfolio aimed to provide a comprehensive review of the current evidence for stroke-specific HR-QOL measurements, as well as the intervention treatments used for post-stroke mood disorders, namely post-stroke depression (PSD), post-stroke anxiety (PSA) and post-stroke emotionalism (PSE).

Design: A systematic review identifies existing HR-QOL measures that are used within the stroke population and assessed them for clinical utility, psychometric properties and coverage of HR-QOL domains. The empirical paper systematically identifies randomised controlled trials (RCTs) on treatment intervention for PSD, PSA and PSE domains. Network meta-analyses (NMA) is conducted on the evidence for each domain to synthesise the findings based on direct and indirect comparisons.

Results & conclusions: The systematic review identified seventeen HR-QOL measures commonly in stroke, and a flow-chart recommending five measures which best met the clinical utility and psychometric criteria. No measure comprehensively covered all HR-QOL domains. The NMA presented the wide range of interventions available for PSD, PSA and PSE, and highlights the disproportionate focus of research within these domains. There is paucity of replicated evidence in the area. Thus, the NMA was not able to provide confident predictions of treatment rankings for either of the domains. Overall, both the systematic review and empirical paper reiterated the need for more quality research in the field.

Keywords: stroke, health-related quality of life, post-stroke mood disorders, post- stroke depression, post-stroke anxiety, post-stroke emotionalism

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Chris White
Date Deposited: 07 Apr 2021 10:40
Last Modified: 07 Apr 2021 10:40


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