Early psychological therapy effective against depression and anxiety in stroke survivors: study

A new study published in the Nature Mental Health revealed that psychological therapy significantly improves mental health outcomes for stroke survivors, particularly when treatment is initiated early.

According to this NHS Talking Therapies program in England, more than one in 3 stroke survivors struggle with depression or anxiety. However, psychological support is often underutilized or delayed in this population. The research analyzed real-world clinical data from 7,597 patients who had previously suffered a stroke, and offers the strongest evidence to date that timely mental health intervention is crucial in post-stroke recovery.

The study found that stroke survivors who received psychological therapy experienced moderate reductions in depressive symptoms and substantial reductions in anxiety. These results reinforce the importance of mental health support as part of stroke rehabilitation.

The patients who began therapy within 6 months of their stroke were far more likely to experience reliable recovery from their mental health symptoms than those who started treatment a year or more after the event. This trend held true even when controlling for variables such as age, gender, socioeconomic status, and baseline severity of symptoms.

This research compared stroke survivors to a matched control group of patients without a stroke history. While both groups showed improvement following therapy, stroke survivors were less likely to achieve reliable recovery and more likely to experience worsening symptoms. However, this disparity narrowed when physical comorbidities were taken into account.

Stroke survivors were less likely to achieve what the study defined as “reliable recovery” in their symptoms of depression or anxiety compared to non-stroke patients, suggesting a unique vulnerability in this group. Also, there was a slightly higher risk of “reliable deterioration” (a significant worsening of symptoms) in stroke survivors, underlining the need for close monitoring.

The patients referred within 6 months of stroke had better recovery rates and lower deterioration than those referred after a year. When adjusting for physical health conditions, the gap in outcomes between stroke and non-stroke patients narrowed, highlighting the complex interplay between physical and mental health.

These findings demonstrates the real-world effectiveness of psychological therapies for stroke survivors and the critical importance of early referral. With mental health proving to be a vital component of recovery, timely therapy could be the difference between long-term struggle and meaningful improvement in quality of life in stroke survivors.

Source:

Suh, J. W., Bell, V., Buckman, J. E. J., El Baou, C., Desai, R., Fearn, C., Marchant, N. L., Richards, M., Cooper, C., Pilling, S., John, A., Stott, J., & Saunders, R. (2025). A record-linkage study of post-stroke primary care psychological therapy effectiveness in England. Nature Mental Health, 3(6), 626–635. https://doi.org/10.1038/s44220-025-00429-z