Ranking psychological interventions for post-stroke depression: A systematic review and network meta-analysis
- Journal
- Psychological medicine (Q1)
- Published
- 21 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Xuerong Cao, Rong Chen, Yingying Qu, Yating Ban, Qi Zhang
- PMID
- 42478229
- DOI
- 10.1017/S0033291726105273
Why clinicians should know about it
- Picked for Pharmacology (medical) (top studies of the week, 26 July 2026).
Abstract
BACKGROUND: Post-stroke depression (PSD) is the most common neuropsychological complication in stroke survivors. While psychological interventions are promising non-pharmacological treatments, the most effective intervention type, as well as their mid- to long-term efficacy and effectiveness across PSD severity levels, remains unclear. This study aims to compare the efficacy of psychological interventions for PSD, focusing on overall effectiveness, mid- to long-term efficacy, and effectiveness across PSD severity levels. METHODS: We systematically searched seven databases for randomized controlled trials (RCTs) of psychological interventions targeting depression in stroke survivors. The primary outcome was depression symptom reduction. Post-intervention, mid- to long-term data were analyzed. A frequentist network meta-analysis (NMA) with random effects was conducted in Stata 17.0. Subgroup analyses by PSD severity were performed. RESULTS: Thirty-eight RCTs involving 3106 participants were included. Post-intervention, third-wave therapies (Hedges' g = -1.08, 95% CI: -1.62 to -0.55) significantly improved PSD compared to treatment as usual. At mid- to long-term follow-up, third-wave therapies (Hedges' g = -0.82, 95% CI: -1.25 to -0.39) maintained significant effects. Relaxation therapy significantly ameliorated mild PSD (Hedges' g = -0.77, 95% CI: -1.27 to -0.27); for moderate-to-severe PSD, no significant effects were observed. CONCLUSIONS: Third-wave therapies are potentially effective for PSD, showing sustained mid- to long-term benefits. Relaxation therapy seems to be most effective for mild PSD, while no significant effects were observed for moderate-to-severe PSD. However, the NMA showed high heterogeneity and generally low to very low evidence certainty for most comparisons, the findings should be interpreted with caution.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.