At least one-third of stroke survivors are affected by depression or anxiety, but no large-scale studies of real-world clinical practice have assessed whether psychological therapies are beneficial for these patients. Here we show that psychological treatment is effective for stroke survivors on average, using national healthcare records from National Health Service Talking Therapies services in England, including 7,597 patients with a hospital diagnosis of stroke before attendance. Following psychological treatment, stroke survivors experienced moderate reductions in depression and large reductions in anxiety symptoms. Patients who started attending the services a year or more after a stroke were less likely to reliably recover from symptoms of depression or anxiety than those seen within six months of a stroke, irrespective of differences in baseline characteristics including age, gender, local area deprivation and symptom severity. Compared with a matched sample of patients without a stroke, stroke survivors were less likely to reliably recover and more likely to reliably deteriorate after psychological treatment, although adjusting for level of physical comorbidity attenuated these relationships. It is crucial that clinicians working with stroke survivors screen for symptoms of depression and anxiety and consider referring patients to primary care psychological therapies as early as possible.

Keywords: Depression; Health services; Stroke.

© The Author(s) 2025.

至少三分之一的中风幸存者会受到抑郁或焦虑的影响，但没有大规模的研究评估心理疗法是否对这些患者有益。在这里，我们使用了来自英格兰国家医疗服务“谈话疗法”服务的全国医疗记录数据（包括7,597名在就诊前被医院诊断为中风的患者），展示了心理治疗对中风幸存者平均来说是有效的。在接受心理治疗后，中风幸存者的抑郁症状有所减轻，焦虑症状大幅减少。那些在中风发生一年或更长时间后再开始接受服务的患者，在恢复抑郁症或焦虑症症状方面的情况比那些在中风发生六个月内就开始接受服务的人要差，无论是在年龄、性别、当地地区的贫困程度和基线症状严重程度等方面是否存在差异。与没有中风病史的匹配样本相比，中风幸存者在接受心理治疗后更不容易明显恢复，并且更容易恶化，尽管调整了身体共患病的程度之后这种关系有所减弱。对于与中风幸存者合作的临床医生来说，筛查抑郁和焦虑症状并尽早将患者转介到初级护理的心理疗法非常重要。

关键词：抑郁症；卫生服务；中风。

© The Author(s) 2025.