Journal Article

Communication and Low Mood (CALM): a randomized controlled trial of behavioural therapy for stroke patients with aphasia

Thomas, Shirley A, Haworth, Helen, Walker, Marion F, Lincoln, Nadina B, Macniven, Jamie A

2013

Overview

Objective: The aim was to evaluate behavioural therapy as a treatment for low mood in people with aphasia. Design: A randomized controlled trial comparing behavioural therapy plus usual care with a usual care control. Potential participants with aphasia after stroke were screened for the presence of low mood. Those who met the criteria and gave consent were randomly allocated. Setting: Participants were recruited from hospital wards, community rehabilitation, speech and language therapy services and stroke groups. Subjects: Of 511 people with aphasia identified, 105 had low mood and were recruited. Interventions: Behavioural therapy was offered for up to three months. Outcomes were assessed three and six months after random allocation. Main measures: Stroke Aphasic Depression Questionnaire, Visual Analog Mood Scales ‘sad’ item, and Visual Analogue Self-Esteem Scale. Results: Participants were aged 29 to 94 years (mean 67.0, SD 13.5) and 66 (63%) were men. Regression analysis showed that at three months, when baseline values and communication impairment were controlled for, group allocation was a significant predictor of the Stroke Aphasic Depression Questionnaire (P < 0.05), visual analogue ‘sad’ (P = 0.03), and Visual Analogue Self-Esteem Scale (P < 0.01). At six months, group alone was a significant predictor of the Stroke Aphasic Depression Questionnaire (P < 0.05), and remained significant when baseline values were controlled for (P = 0.02). Mean Stroke Aphasic Depression Questionnaire 10-item hospital version scores decreased from baseline to six months by six points in the intervention group as compared with an increase of 1.9 points in the control group. Conclusions: Behavioural therapy seemed to improve the mood of people with aphasia.

• Publisher: SAGE Publications,Sage Publications Ltd
• Subject: Adult / Aged / Aged, 80 and over / Allocation / Aphasia / Aphasia - etiology / Aphasia - psychology / Aphasia - rehabilitation / Behavior / Behavior modification / Behaviour therapy / Clinical assessment / Clinical trials / Cognitive Therapy - methods / Communication / Communication Disorders / Consent / Dementia / Depression / Emotions / Evaluative Studies / Female / Group therapy / Groups / Hospital wards / Humans / Language / Language therapy / Male / Measures / Medical treatment / Mental depression / Middle Aged / Mood Disorders - etiology / Mood Disorders - therapy / Moods / Patients / Questionnaires / Randomized controlled trials / Regression Analysis / Rehabilitation / ROC Curve / Self Concept / Self esteem / Speech therapy / Statistics, Nonparametric / Stroke / Stroke - complications / Stroke - psychology / Stroke Rehabilitation / Strokes / Therapy / Visual Analog Scale