scholarly journals Implication of problematic substance use in poststroke depression: an hospital-based study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yolaine Rabat ◽  
Igor Sibon ◽  
Sylvie Berthoz
Keyword(s):  
Substance Use ◽  
Depression Scale ◽  
Severe Depression ◽  
Epidemiological Studies ◽  
Stroke Patients ◽  
Addictive Disorders ◽  
Post Stroke ◽  
Problematic Substance Use ◽  
Problematic Substance

AbstractThe prevalence of clinically defined problematic substance use among stroke patients is overlooked and its association with post-stroke depression (PSD) is unknown. Our aims were to: (1) estimate the proportion of stroke patients with a problematic substance use as defined by clinical screening scales; (2) determine the proportion of PSD at three months of follow-up; (3) explore if the baseline severity in substance use and its evolution are independent predictors of PSD. A cohort of first-ever non-severe stroke adult patients was screened at baseline and three months post-stroke using recommended cut-off scores of standardized scales for tobacco, alcohol and cannabis abuse. PSD was defined using the Center of Epidemiological Studies Depression scale score. Out of the 244 eligible patients, 74 (30.3%) presented a problematic substance use, including 21 (8.6%) polydrug abusers. Among these patients, the prevalence of PSD was 50.8%, including 29.5% of severe depression. The severity of tobacco dependence at baseline was found to double the risk (OR 1.59, 95% CI 1.05–2.43) of presenting a PSD, independently of previously reported risk factors. We found no significant evidence for an effect of the evolution in substance use at follow-up. Addictive disorders are part of the critical unmet needs that should be addressed in the management of PSD.

scholarly journals Assessment of Quality of Life and Incidence of Depression in Post Stroke Patients

2020 ◽  
Vol 11 (4) ◽  
pp. 7146-7150
Author(s):  
Aditya Dharman ◽  
Chandrina Loungchot ◽  
Ven Davis ◽  
Mahshid Delavari ◽  
Binai K Sankar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Depression Scale ◽  
Severe Depression ◽  
The Elderly ◽  
Hamilton Depression Scale ◽  
Early Assessment ◽  
Stroke Patients ◽  
Post Stroke

Depression is a common illness worldwide. Social, psychological and biological factors can lead to depression. Chronic illness among the elderly is a significant reason affecting mental health. Often it is not diagnosed correctly. An observational study was conducted to assess the quality of life and the incidence of depression in post-stroke patients. Subjects were recruited to the study by investigations during ward/OP visits. The subjects were briefed about the study, and informed consent was obtained. Data were collected using various study tools and analyzed statistically by computing proportion for all qualitative data and mean, standard deviation, median, the interquartile range for quantitative data. A total of 50 subjects were enrolled in the study based on inclusion and exclusion criteria. Severe cognitive impairment was revealed in 14% of the patients. The burden of depression and severity was evaluated using Patient health questionnaire-9 and Hamilton depression scale, respectively. It was found that 22 subjects (44%) had moderate depression, while 2 (4%) had severe depression. The functionality of the subjects was measured and found that 18% of subjects were 'dependent' on their caregiver. SSQOL assessment showed the lowest score in the domains 'work & productivity' and 'energy". As much as treating the etiological factors of stroke, dealing with the mental aspect of stroke is necessary. Assessing and treating post-stroke depression is essential to reduce the morbidity and mortality of patients. Hence, early assessment and management of mental health after stroke is necessary to prevent a chance of developing another stroke.

The Sensitivity and Specificity of the Center for Epidemiologic Studies Depression Scale in Screening for Post-Stroke Depression

1989 ◽  
Vol 18 (2) ◽  
pp. 169-181 ◽  
Author(s):  
Rajesh M. Parikh ◽  
Dianne T. Eden ◽  
Thomas R. Price ◽  
Robert G. Robinson
Keyword(s):  
Sensitivity And Specificity ◽  
Depression Scale ◽  
Screening Instrument ◽  
Epidemiologic Studies ◽  
Stroke Patients ◽  
Post Stroke ◽  
Standardized Interview ◽  
Post Stroke Depression ◽  
One Year

The present study examines the sensitivity and specificity of the Center for Epidemiologic Studies Depression Scale (CES-D) as a screening instrument for post-stroke depression. Eighty stroke patients were evaluated by a research nurse over a two-year period using the CES-D and also by a trained psychiatrist using a standardized interview for affective, cognitive, physical and social functioning. CES-D scores correlated significantly with DSM-III diagnoses of depression in-hospital and at three months, six months, and one year follow-up but not at two years follow-up, reflecting the natural course of these depressions, as well as the predictive validity of the CES-D. Furthermore, at a cut-off point of 16, the CES-D was found to have a specificity of 90 percent, a sensitivity of 86 percent and a positive predictive value of 80 percent and thus may be a potentially useful screening instrument for post-stroke depression.

scholarly journals A controlled trial of screening, brief intervention and referral for treatment (SBIRT) implementation in primary care in the United Arab Emirates

2017 ◽  
Vol 19 (02) ◽  
pp. 165-175 ◽  
Author(s):  
Catriona Matheson ◽  
Christiane Pflanz-Sinclair ◽  
Amna Almarzouqi ◽  
Christine M Bond ◽  
Amanda J Lee ◽  
...  
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
United Arab Emirates ◽  
Brief Intervention ◽  
Primary Care Physicians ◽  
Controlled Trial ◽  
Care Clinic ◽  
Problematic Substance Use ◽  
Problematic Substance

Aim This project evaluated the effectiveness of screening brief intervention and referral for treatment (SBIRT) in primary care in Abu Dhabi to manage patients with problematic substance use. This study aimed to determine whether: (i) training primary care physicians on the SBIRT model increased the identification of patients using substances at a harmful, hazardous or dependent level; (ii) training improved physicians’ knowledge, attitudes and beliefs in self-efficacy in managing substance use. Background Substance use is increasing in the United Arab Emirates yet there has been no formal primary care intervention. SBIRT was considered an appropriate model given its endorsement by the WHO. Methods A controlled trial (two intervention and two matched control clinics) was undertaken. Intervention physicians (n=17) were trained in SBIRT. Physicians’ attitudes were measured before and after training and eight months after implementation. Target recruitment was 900 patients. Inclusion criteria were: consenting UAE national, ⩾18 years, using the ‘walk-in’ primary care clinic. Patient data was collected by physician-administered questionnaire. Prevalence of drug use was measured through electronic patient records. Findings A total of 906 patients were screened, aged 18–82 years and 496 (55%) were female. Of these, 5.7% reported use of amphetamine, 3.9% alcohol, 3.3%, sedatives, 1.7% opioids and 1.1% cannabis. In all, 21 people had a moderate/high ASSIST score and received a brief intervention, but did not attend follow-up; three high-risk people were referred for specialist treatment. Physicians’ attitudes towards patients with problematic substance use and providing treatment improved after training, but returned to pre-training levels after eight months. Including the 21 individuals identified from intervention screening, the prevalence of substance use increased to 0.208% (95% CI 0.154–0.274), significantly higher than in control clinics (P<0.001). In conclusion, physicians were generally positive towards SBIRT and SBIRT increased recorded drug related conditions at a practice level. However, poor patient attendance at follow-up requires investigation.

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