From the Departments of Psychiatry and Behavioral Sciences (R.K., R.C.V.), Biostatistics and Office for Nursing Research (K.C.C.), Biobehavioral Nursing & Health Systems (A.B., P.H.M.), Neurology and Neurological Surgery (K.J.B.), and Psychosocial and Community Health (L.T.), University of Washington, Seattle, WA; and the Department of Neurology (V.J., D.J.T.), University of Washington Stroke Center, Seattle, WA.
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Background and Purpose—The Living Well With Stroke study has demonstrated effectiveness of a brief psychosocial treatment in reducing depressive symptoms after stroke. The purpose of this analysis was to determine whether key variables associated with prevalence of poststroke depression also predicted treatment response.Methods—Response to a brief psychosocial/behavioral intervention for poststroke depression was measured with the Hamilton Rating Scale for Depression. Analysis of covariance models tested for interaction of potential predictor variables with treatment group on percent change in Hamilton Rating Scale for Depression from pre- to post-treatment as an outcome.Results—Initial depression severity, hemispheric location, level of social support, age, gender, and antidepressant adherence did not interact with the treatment with respect to percent change in Hamilton Rating Scale for Depression when considered 1 at a time. Participants who carried 1 or 2 s-alleles at the 5-HTTLPR serotonin transporter polymorphism or 1 or 2 9- or 12-repeats of the STin2 VNTR polymorphism had significantly better response to psychosocial treatment than those with no s-alleles or no 9- or 12-repeats.Conclusions—Opposite to the effects of antidepressant drug treatment with selective serotonin reuptake inhibitors, the Living Well With Stroke psychotherapy intervention was most effective in 5-HTTLPR s-allele carriers and STin2 VNTR 9- or 12-repeat carriers.Clinical Trial Registration—URL: www.clinicaltrials.gov/ct/show/NCT00194454?order_1. Unique identifier: NCT00194454.