Comparing the Effect of Kootker's Cognitive-behavioral Therapy Combined with Transcranial Direct Current Stimulation or Pharmacotherapy with Citalopram on Improvement of Depressive Symptoms and Working Memory in Stroke Patients: A Randomized Clinical

Background: Stroke is the leading cause of severe physical and cognitive disability across the globe. Objectives: The present study sought to compare the effect of Kootker's cognitive behavioral therapy (CBT) combined with transcranial direct current stimulation (tDCS) or pharmacotherapy with citalopram on the improvement of depression symptoms and working memory of stroke patients. Materials and Methods: In this study, we adopted a quasi-experimental pretest-posttest control group design. The population of this study included all stroke sufferers who were referred to a neurology clinic in Zahedan in ۲۰۲۲. Among this population, ۴۵ cases were selected via the available sampling method and randomly assigned to three groups (n=۱۵). To assess depression, Beck's Depression Inventory and N-back tests were employed at pre-test, post-test, and ۳-month follow-up. The first experimental group underwent CBT and ۲۰ sessions of anodal stimulation of the dorsolateral prefrontal cortex, while the second experimental group underwent CBT and ۱۰ mg citalopram daily. The control group did not receive any intervention. Results: The results of mixed analysis of variance highlighted the short-term and long-term effectiveness of both interventions in the improvement of depression symptoms of stroke patients (P<۰.۰۵), and no difference was observed between the efficacy of the two combined interventions. Furthermore, the combined intervention of CBT and tDCS had a short-term effect on the improvement of working memory. Conclusion: As evidenced by the obtained results, it can be concluded that both combined interventions can be of great help in improving depression symptoms among stroke sufferers.

Keywords:

Cognitive-Behavioral Therapy , Pharmacotherapy , symptoms of depression , working memory , Stroke