A comprehensive rehabilitation program for the management of anxiety and depressive disorders in post-stroke patients

Abstract

Background. Emotional disorders such as anxiety and depression are frequent consequences of stroke that significantly impair patients' quality of life and impede neurorehabilitation. The limited efficacy of conventional approaches necessitates the development and evaluation of integrated rehabilitation programs designed to address the emotional disturbances in this population. Aims. This study aimed to evaluate the efficacy of a comprehensive rehabilitation program, including psychopharmacotherapy, cognitive behavioral therapy, art therapy, and autogenic training, for the management of anxiety and depressive disorders in post-stroke patients. Materials and methods. The study involved 40 patients (28 women and 12 men) aged 48 to 75 years (mean age 61.5 ± 8.2 years) with a history of stroke (at least 3 months post-event) and diagnosed anxiety and depressive disorders. The Hospital Anxiety and Depression Scale (HADS) and the Beck Depression and Anxiety Inventories (BDI-II, BAI) were used to assess symptom severity. The comprehensive intervention comprised pharmacotherapy (SSRIs), cognitive behavioral therapy (SMEER technique), art therapy (drawing a picture of illness and health), and Schultz’s autogenic training. Statistical analysis was performed using Student's paired t-test. Results. Prior to the intervention, patients exhibited elevated levels of anxiety and depression on all scales. Upon completion of the program, a statistically significant reduction in scores was observed on all measures (p < 0.001), indicating a marked improvement in patients’ emotional states. The mean HADS-anxiety score decreased from 8.175 ± 4.56 to 3.65 ± 2.47, and the mean HADS-depression score decreased from 7.975 ± 3.17 to 3.475 ± 2.36. Conclusion. A comprehensive rehabilitation program integrating psychopharmacotherapy, cognitive behavioral therapy, art therapy, and autogenic training is an effective intervention for the management of anxiety and depressive disorders in post-stroke patients. These findings underscore the importance of timely diagnosis and a multimodal approach to treating emotional disorders within stroke rehabilitation protocols.