Abstract: Background　At present，little attention has been paid to patients with post-stroke subthreshold depression in China，and the effect of behavioral activation therapy on such patients is still unclear.Objective　To explore the effect of behavioral activation therapy on depressive symptoms and behavioral characteristics and incidence of post-stroke depression in post-stroke subthreshold depression patients.Methods　We enrolled 30 cases suffering from post-stroke subthreshold depression for no more than 3 months from Department of Neurology or Department of Rehabilitation，Daqing People's Hospital during October 2017 to March 2018.By use of a random number table，we equally divided them into intervention group （n=15） and control group （n=15）.Both groups were given the conventional mental health intervention，the intervention group were also treated with a 6-week behavioral activation therapy（once a week，30-60 min at a time）．Center for Epidemiological Survey，Depression Scale （CES-D），Behavioral Inhibition System and Behavioral Activation System Scale （BIS/BAS），and 17-item Hamilton Depression Scale （HAMD-17） were used to assess the depressive symptoms，behaviors and depressive state，respectively，at baseline，at the end of intervention and 3 months after the intervention.Intervention outcomes of both groups were evaluated by scores of CES-D，BIS/BAS and HAMD-17.Results　Both the method and duration of intervention had obviously interactive effect on the average scores of CES-D and BAS （P<0.05）．And they produced significant main effects on the average scores of CES-D and BAS （P<0.05）．Intergroup comparisons showed that at the end of intervention and 3 months after intervention，the intervention group had lower average score of CES-D and higher average score of BAS （P<0.05）．The average score of CES-D decreased significantly and that of the BAS increased notably in both groups at the end of intervention and 3 months after intervention compared to the baseline （P<0.05）．The outcome of post-stroke subthreshold depression was similar in both groups at the end of the intervention （P>0.05），but it was much better in the intervention group 3 months later（P<0.05）．Conclusion　Our trial shows that behavioral activation therapy can improve the depressive symptoms and behavioral characteristics of patients suffering from post-stroke subthreshold depression for no more than 3 months，and reduce the incidence of post-stroke depression within 6 months after stroke.

Key words: Stroke, Depression, Behavioral activation intervention, Intervention studies

摘要： 背景　目前我国对脑卒中后阈下抑郁患者的关注较少，且行为激活疗法应用于脑卒中后阈下抑郁患者的效果尚不明确。目的　探讨行为激活疗法对脑卒中后阈下抑郁患者抑郁症状及行为特征的干预效果，并进一步对比分析患者脑卒中后抑郁的发生情况。方法　选取2017年10月—2018年3月大庆市人民医院神经内科或康复科诊治的病程≤3个月脑卒中后阈下抑郁患者30例，采用随机数字表法分为干预组（n=15）和对照组（n=15）。对照组实施常规心理健康教育，干预组在对照组基础上实施行为激活疗法干预，1次/周、30~60 min/次，为期6周。干预前、干预后及干预结束后3个月采用流调用抑郁量表（CES-D）、行为抑制/行为激活系统量表（BIS/BAS）、17项汉密尔顿抑郁量表（HAMD-17）评价两组的干预效果。结果　干预方法与时间在CES-D、BAS评分上存在交互作用（P<0.05）；干预方法主效应显著（P<0.05）；时间主效应显著（P<0.05）。其中干预后、干预结束后3个月，干预组CES-D评分低于对照组，BAS评分高于对照组（P<0.05）；干预组干预后、干预结束后3个月CES-D评分较干预前降低，BAS评分较干预前升高（P<0.05）。干预后，两组患者阈下抑郁转归比较，差异无统计学意义（P>0.05）；干预结束后3个月，两组患者阈下抑郁转归比较，差异有统计学意义（P<0.05）。结论　行为激活疗法可改善病程≤3个月脑卒中后阈下抑郁患者抑郁症状，提高其行为激活水平，降低脑卒中后6个月时脑卒中后抑郁发病率。

关键词: 脑卒中, 抑郁, 行为激活疗法, 干预性研究