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 Morphological and Metabolic Alteration of Cerebellum in Patients with Post-Stroke Depression

2016 ◽  
Vol 40 (3-4) ◽  
pp. 420-430 ◽  
Author(s):  
Ling Zhang ◽  
Rubo Sui ◽  
Lei Zhang ◽  
Zhuang Zhang
Keyword(s):  
Magnetic Resonance ◽  
Depression Scale ◽  
Resonance Spectroscopy ◽  
Hamilton Depression Scale ◽  
Stroke Patients ◽  
1H Mrs ◽  
Post Stroke ◽  
Cont Group ◽  
Post Stroke Depression ◽  
Norm Group

Background: To study morphological and metabolic changes of cerebellum with multimodality magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H-MRS), respective, to explore correlation between cerebellum alteration and severity of depression in patients with post-stroke depression. Methods: 60 subjects, including 40 stroke patients and 20 healthy volunteers were enrolled. Depression of stroke patients was tested by Self-rating Depression Scale (SDS) and Hamilton Depression Scale (HAMD), based on which stroke-patients were grouped into post-stroke depression (PSD group) and without post-stroke depression (CONT group). Results: Volume of cerebellum decreased in PSD group and CONT group compared with healthy volunteer (NORM) group. White matter of cerebellum in PSD group and CONT group was disrupted; such disruption was significantly in PSD group. In addition, there was correlation between cerebellum volume and FA and HDRS scores (P<00.01). The Cho/Cr and Cho/NAA ratios in cerebellum contralateral to stroke lesion in PSD were higher than those in NORM group (P<0.05). Cho/Cr and Cho/NAA ratios in contralateral cerebellum and ratio difference of Cho/Cr in bilateral cerebellum were positively correlated with HAMD scales (P<0.05). Conclusion: Morphologic and metabolic alterations are evident in patients with post-stroke depression, indicating possible involvement of cerebellum in post-stroke-depression occurrence.

Abstract 21: Sex Differences in Post-Stroke Depression in the Elderly

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Naomi Mayman ◽  
Stanley Tuhrim ◽  
Nathalie Jette ◽  
Mandip S Dhamoon ◽  
Laura K Stein
Keyword(s):  
Sex Differences ◽  
Ischemic Stroke ◽  
Time Course ◽  
Cox Regression ◽  
Cumulative Risk ◽  
The Elderly ◽  
Stroke Patients ◽  
Post Stroke ◽  
Post Stroke Depression

Introduction: Post-stroke depression (PSD) occurs in approximately one-third of ischemic stroke patients. However, there is conflicting evidence on sex differences in PSD. Objective: We sought to assess sex differences in risk and time course of PSD in US ischemic stroke (IS) patients. We hypothesized that women are at greater risk of PSD than men, and that a greater proportion of women experience PSD in the acute post-stroke phase. Methods: Retrospective cohort study of 100% de-identified data for US Medicare beneficiaries ≥65 years admitted for ischemic stroke from July 1, 2016 to December 31, 2017. We calculated Kaplan-Meier unadjusted cumulative risk of depression, stratified by sex, up to 1.5 years following index admission. We performed Cox regression to report the hazard ratio (HR) for diagnosis of depression up to 1.5 years post-stroke in males vs. females, adjusting for patient demographics, comorbidities, length of stay, and acute stroke interventions. Results: Female stroke patients (n=90,474) were 20% more likely to develop PSD than males (n=84,427) in adjusted models. Cumulative risk of depression was consistently elevated for females throughout 1.5 years of follow-up (0.2055 [95% CI 0.2013-0.2097] vs. 0.1690 [95% CI 0.1639-0.1741] (log-rank p<0.0001). HR for PSD in females vs. males remained significant in fully adjusted analysis at 1.20 (95% CI 1.17-1.23, p<0.0001). Conclusions: Over 1.5 years of follow-up, female stroke patients had significantly greater hazard of developing PSD, highlighting the need for long-term depression screening in this population and further investigation of underlying reasons for sex differences.

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 Clinical utility of chosen factors in predicting post-stroke depression: a one year follow-up.

2015 ◽  
Vol 49 ◽  
pp. 683-696 ◽  
Author(s):  
Hubert Wichowicz ◽  
Dariusz Gąsecki ◽  
Jerzy Landowski ◽  
Piotr Lass ◽  
Małgorzata Świerkocka ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Post Stroke ◽  
Post Stroke Depression ◽  
One Year

scholarly journals P.015 What Happens to the Worried Well? – Follow-up of Subjective Cognitive Impairment

2021 ◽  
Vol 48 (s3) ◽  
pp. S24-S24
Author(s):  
M Sutherland ◽  
A Kirk ◽  
C Karunanayake ◽  
M O’Connell ◽  
D Morgan
Keyword(s):  
Depression Scale ◽  
Epidemiologic Studies ◽  
Remote Memory ◽  
Initial Assessment ◽  
Significant Difference ◽  
Mini Mental Status Examination ◽  
One Year ◽  
Neurocognitive Decline ◽  
Over Time

Background: Concern around perceived neurocognitive decline is increasing, leading to increased number of referrals and anxiety for patients. We aimed to explore the likelihood of the “worried well” experiencing neurocognitive decline. Methods: 166 “worried well” patients who attended the Rural and Remote Memory Clinic between 2004 and 2019 were included. Mini Mental Status Examination, Center for Epidemiologic Studies Depression Scale, and Functional Assessment Questionnaire scores were measured and compared at initial assessment and at 1-year follow-up. MMSE scores over time were assessed with a mean follow-up of 2.95 years (SD 2.87). Results: There was no statistically significant difference in MMSE, CESD, or FAQ scores between clinic day and one-year follow-up, and no consistent pattern of MMSE score over time. Of the 166 patients with SCI on initial assessment, nine were eventually given a neurological diagnosis. Conclusions: There is no pattern of neurologic decline observed in the “worried well”. Though the likelihood of a patient with SCI developing a neurological diagnosis is reassuringly low, (9/166), it is not irrelevant. This, along with the benefits of early diagnosis and treatment for dementia, leads us to believe that patients with SCI should still be seen in follow-up at least at the one-year mark.

scholarly journals Early-Onset Depression in Stroke Patients: Effects on Unfavorable Outcome 5 Years Post-stroke

2021 ◽  
Vol 12 ◽  
Author(s):  
Ya-Ying Zeng ◽  
Meng-Xuan Wu ◽  
Dan-Dan Geng ◽  
Lin Cheng ◽  
Sheng-Nan Zhou ◽  
...  
Keyword(s):  
Early Onset ◽  
Depression Scale ◽  
Unfavorable Outcome ◽  
Chinese Patients ◽  
Hamilton Depression Scale ◽  
Post Stroke ◽  
Potential Risk Factors ◽  
Post Stroke Depression ◽  
State Examination

Background: Post-stroke depression (PSD) constitutes an essential complication of stroke and is associated with high-risk unfavorable outcome after stroke. The main objective of this prospective study was to determine the relationship between early-onset PSD (1 month after stroke) and functional outcomes 5 years after baseline enrollment.Methods: Four hundred thirty-six patients who met the criteria were included in this study from October 2013 to February 2015. The follow-up time for each patient was ~5 years, with follow-up every 3 months. Patients received questionnaires including the 17-item Hamilton Depression Scale (HAMD), the Mini-Mental State Examination (MMSE), the National Institutes of Health Stroke Scale (NIHSS), the modified Rankin Scale (mRS), and the Barthel Index (BI).Results: Of the 436 patients, 154 (35.3%) patients with the prevalence of PSD status at baseline, 26 (7.2%) patients with the prevalence of PSD status, and 73 (20.1%) had an unfavorable outcome 5 years after stroke. The odds ratio (OR) for unfavorable outcome at 5 years in the PSD group was ~2.2 relative to the non-PSD group after adjusting for potential risk factors [OR = 2.217, 95% confidence interval (CI) = 1.179–4.421, P = 0.015]. In the early-onset PSD group, HAMD scores were independently associated with 5-year unfavorable outcome rates (OR = 1.168, 95% CI = 1.015–1.345, P = 0.031).Conclusions: Our findings indicate that early-onset PSD status in Chinese patients is an independent risk factor for unfavorable outcome 5 years after stroke, and that the severity of PSD is also related to unfavorable outcome.

scholarly journals Psychiatric Nurses Providing Post-Stroke Depression Education to Care Partners of Stroke: A Pilot Study

2019 ◽  
Vol 1 (2) ◽  
pp. 73-81
Author(s):  
Patricia Zulim ◽  
Anjali Perera ◽  
Sonja Stutzman ◽  
Daiwai Olson
Keyword(s):  
Pilot Study ◽  
Family Members ◽  
Psychiatric Nurses ◽  
Stroke Patients ◽  
Post Stroke ◽  
Care Partners ◽  
Significant Difference ◽  
Post Stroke Depression ◽  
Knowledge Of Depression

Background: Stroke survivors are a higher risk for post-stroke depression (PSD) after they return home from the hospital. Given that many stroke patients have friends or family members (care partners) present after hospital discharge, this pilot study examined the utility of psychiatric nurses educating family members on how to recognize PSD. Methods: This pilot study identified stroke patients and their care partner while they were in the hospital, to provide education on depressive symptoms, community resources, safety resources (e.g., suicide hotline), how to address symptoms of depression with their care partner. A descriptive observational design was used wherein a psychiatric delivered PSD education to the patient’s care partner (instead of the patient). Knowledge of depression was assessed immediately prior to-, immediately after-, and at a 2-week follow-up after-, the education intervention. Results: This pilot study was not powered to detect a statistically significant difference. However, among the 20 subjects (mean age 61 years), fewer scores fell in the lower range (less knowledge of depression) immediately after the education and at the 2-week follow-up phone call. Conclusion: This study demonstrates the potential of multi-disciplinary nursing consultation to improve outcomes.

Therapy of post-stroke depression – a systematic review

2013 ◽  
Vol 10 (02) ◽  
pp. 108-129 ◽  
Author(s):  
W. Gaebel ◽  
W. Wannagat ◽  
J. Zielasek
Keyword(s):  
Systematic Review ◽  
Large Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Placebo Control ◽  
Post Stroke ◽  
Pharmacological Studies ◽  
Post Stroke Depression ◽  
Control Procedures ◽  
Antidepressant Pharmacotherapy

SummaryWe performed a systematic review of randomized placebo-controlled pharmacological and non-pharmacological trials for the therapy and prevention of post-stroke depression that have been published between 1980 and 2011. We initially identified 2 260 records of which 28 studies were finally included into this review. A meta-analytic approach was hampered by considerable differences regarding the kinds of therapeutic regimens and the study durations. Modest effects favoring treatment of post-stroke depression could be found for pharmacological treatment as well as repetitive transcranial magnetic stimulation. For the prevention of post-stroke depression, antidepressant pharmacotherapy showed promising results. However, large-scale studies with better standardized study populations, optimized placebo control procedures in non-pharmacological studies, and replication in larger follow-up studies are still necessary to find the optimal therapeutic regimens to prevent and treat post-stroke depression.

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