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Thomas, Shirley A. and Walker, Marion F. and Macniven, Jamie A. and Haworth, Helen and Lincoln, Nadina (2013) Communication and Low Mood (CALM): a randomized controlled trial of behavioural therapy for stroke patients with aphasia. Clinical Rehabilitation, 27 (5). pp. 398-408. ISSN 0269-2155

Abstract

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.

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