Depressive symptoms in stroke patients: A 13 month follow-up study of patients referred to a rehabilitation unit

Abstract Background Although depression is known to be frequently associated with stroke, it is nonetheless underdiagnosed and under-treated in this patient population. Its effect on outcome for stroke patients is thought to be substantial, but prediction is complicated by other pre- and post stroke...

Full description

Saved in:
Bibliographic Details
Published in:Journal of affective disorders 2010-12, Vol.127 (1), p.211-218
Main Authors: Farner, Lasse, Wagle, Jørgen, Engedal, Knut, Flekkøy, Kjell M, Wyller, Torgeir Bruun, Fure, Brynjar
Format: Article
Language:English
Subjects:
Activities of Daily Living - classification
Activities of Daily Living - psychology
Adult and adolescent clinical studies
Aged
Aged, 80 and over
Assessment
Biological and medical sciences
Cognition
Cognition Disorders - diagnosis
Cognition Disorders - mortality
Cognition Disorders - psychology
Cognitive impairment
Depression
Depressive Disorder - diagnosis
Depressive Disorder - mortality
Depressive Disorder - psychology
Female
Follow-Up Studies
Home Care Services - utilization
Humans
Male
Medical sciences
Mental Status Schedule - statistics & numerical data
Middle Aged
Minimental State Examination
Mood disorders
Neurology
Norway
Outcome
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychometrics
Psychopathology. Psychiatry
Referral and Consultation
Rehabilitation
Rehabilitation Centers
Risk Factors
Social activities
Social Adjustment
Stroke
Stroke - mortality
Stroke - psychology
Stroke Rehabilitation
Strokes
Survival Analysis
Utilization Review
Vascular diseases and vascular malformations of the nervous system
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Although depression is known to be frequently associated with stroke, it is nonetheless underdiagnosed and under-treated in this patient population. Its effect on outcome for stroke patients is thought to be substantial, but prediction is complicated by other pre- and post stroke factors. The aims of this study was to describe changes in depressive symptoms in elderly stroke patients across a timespan of one year, to examine risk factor for such changes and to explore whether depressive symptoms have any independent impact upon one year mortality and nursing home placement. Methods 194 patients diagnosed with an ischaemic or hemorrhagic stroke was recruited from the Stroke Rehabilitation Unit, Ullevaal University Hospital, Oslo, Norway during the period between March 2005 and August 2006 and followed up for a period of 13 months. Pre-stroke assessment was accomplished by means of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), the Frenchay Activities Index (FAI), the Barthel ADL Index and patient's medical history. Post-stroke assessment at inclusion and follow-up examination was performed with the Mini Mental State Examination (MMSE), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Star Cancellation Test, the Barthel ADL Index, the modified Rankin Scale (mRS) and the National Institute of Health Stroke Scale (NIHSS). Information was collected from the patients' records. Results Institutionalization at 13 months was predicted by more depression (MADRS) and cognitive impairment (RBANS) at baseline, together with lower pre-stroke social activity levels (FAI). Two factors predicted death at 13 months: Cognitive impairment (MMSE) and greater age. The prevalence of depression was relatively unchanged from baseline (56%) to 13 month follow-up (48%). Among the patients who were depressed at baseline 55% still had MADRS score above six (persistent depression) at 13 months, while 35% in the non-depressed group at baseline had developed depression (incident depression). Persistent depression was significantly predicted by lower pre-stroke social activity levels (FAI) together with a more severe stroke (NIHSS) and worse overall function (mRS) at baseline. Incident depression was predicted by receipt of municipal home help before the stroke and a lower score on the delayed memory tasks on RBANS at baseline.
ISSN:0165-0327
1573-2517
DOI:10.1016/j.jad.2010.05.025