Post-Stroke Depression: Outcome following Rehabilitation

1995 ◽  
Vol 29 (4) ◽  
pp. 609-614 ◽  
Author(s):  
Chan Keen Loong ◽  
NG Kwan Chung Kenneth ◽  
Straughan T. Paulin
Keyword(s):  
Functional Assessment ◽  
Rating Scale ◽  
Negative Impact ◽  
Functional Improvement ◽  
Physical Impairment ◽  
Rehabilitation Centre ◽  
Post Stroke ◽  
Depressed Patients ◽  
Post Stroke Depression ◽  
Hamilton Rating Scale

Objective: This prospective study looks at the outcome of rehabilitation on mood and physical recovery in patients with post-stroke depression. Methods: Fifty-two patients in a rehabilitation centre were assessed for depression, modified Barthel's score and Hamilton Rating Scale for depression on admission to and discharge from the rehabilitation centre. Aphasic, demented and delirious patients were excluded. Results: Fifty-five percent of the patients were assessed to have depression on admission and 98% had physical impairment. At the time of discharge, only 28.6% were depressed and two-thirds had improved in physical function. Patients with ail degrees of functional impairment showed equal improvement and there was no difference between Barthel's scores for patients whose mood improved and those who remained depressed. There were very strong associations between functional assessment and depression, functional assessment on discharge with depression on admission, and patients' mood on admission and discharge. Depressed patients did not stay longer in the rehabilitation centre than non-depressed patients. Low doses of anti-depressants did not have an impact on mood or functional improvement. Conclusion: We have found that depression might not have a clear negative impact on rehabilitation, that mood improved at the end of rehabilitation and that the degree of depression on admission was a good predictor of the outcome of final physical impairment.

scholarly journals Decreased Npas4 expression in patients with post-stroke depression

2019 ◽  
Vol 7 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Shina Gu ◽  
Xiaodan Li ◽  
Lin Zhao ◽  
Huicong Ren ◽  
Chendi Pei ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Mononuclear Cells ◽  
Rating Scale ◽  
Control Group ◽  
Peripheral Blood Mononuclear ◽  
Post Stroke ◽  
Stroke Group ◽  
Post Stroke Depression ◽  
Hamilton Rating Scale

Purpose:Post-stroke depression (PSD) is a frequent neuropsychiatric disorder following stroke which is associated with poor outcome. Neuronal Per-Arnt-Sim (PAS) domain protein 4 (Npas4) is associated with cognitive function. Npas4 expression in peripheral blood mononuclear cells (PBMCs) from patients with PSD was measured to find new therapeutic strategy.Patients and methods:Ischemic stroke patients (n = 152) within 1 week of stroke onset were recruited. At 3 months follow-up, the patients were divided into a PSD group (n = 77) and a stroke group (n = 75) using the Hamilton Rating Scale. Healthy subjects (n = 75) were also recruited in the study. The PSD group received 12 weeks of duloxetine treatment. Cognitive function was evaluated using the P300 test. Npas4 expression in PBMCs was measured by quantitative RT-PCR (qPCR).Results:Before treatment, P300 latencies in the PSD group were prolonged and the P300 amplitudes were lower than the control group (P < 0.01). Npas4 expression in the PSD group was also lower than the control group (P < 0.01). After treatment, the P300 latencies were reduced and the amplitudes were significantly elevated in the PSD group compared to that before treatment (P < 0.01). Meanwhile, Npas4 levels were significantly higher than that before treatment (P < 0.01). Npas4 expression was positively correlated to the P300 amplitudes (P < 0.05).Conclusion:Changes of Npas4 expression in PBMCs are associated with cognitive impairment in PSD patients and new therapeutic options applying Npas4-related transcript mechanism could be considered in the future.

scholarly journals Post-Stroke Depression and Its Effect on Functional Outcomes during Inpatient Rehabilitation

2021 ◽  
Author(s):  
Gurumayum Sonachand Sharma ◽  
Anupam Gupta ◽  
Meeka Khanna ◽  
Naveen Bangarpet Prakash
Keyword(s):  
Outcome Measures ◽  
Functional Outcomes ◽  
Rating Scale ◽  
Tertiary Care ◽  
Depression Scale ◽  
Inpatient Rehabilitation ◽  
University Hospital ◽  
Post Stroke ◽  
Significant Difference ◽  
Post Stroke Depression

Abstract Objective The aim of the study is to observe the effect of post-stroke depression on functional outcomes during inpatient rehabilitation. Patients and Methods The design involved is prospective observational study. The location involved is Neurological Rehabilitation unit in a tertiary care university hospital. The study period ranges from October 2019 to April 2020. The participants involved are the patients with first ever stroke, male and female with age ≥18 years and duration less than 1 year. All participants were assessed at admission and after 14 sessions of inpatient rehabilitation by depression subscale of Hospital Anxiety and Depression Scale (HADS-D) and Hamilton Depression Rating Scale (HDRS). The stroke outcomes measures used were: Barthel Index (BI), Scandinavian Stroke Scale (SSS), and Modified Rankin Scale (MRS). Results There are a total of 30 participants (18 males) with median stroke duration of 90 days. The median age of the patients was 58 years. Sixteen patients had ischemic and 14 had hemorrhagic stroke. Out of these, 57% (n = 17) had symptoms of depression (HADS-D >7). Participants in both groups (with and without depression) showed improvement in all the functional outcome measures (BI, SSS, MRS) at the time of discharge as compared with admission scores. The changes in the outcome measures were statistically significant within groups (p < 0.05) but not significant between the groups (p > 0.05). Conclusion The post-stroke depression is common among stroke survivors of less than 1 year duration. There was no significant difference in the functional outcomes between stroke patients with depression and those without depression with inpatient rehabilitation program.

Is There a Delay in the Onset of the Antidepressant Effect of Electroconvulsive Therapy?

1994 ◽  
Vol 164 (1) ◽  
pp. 106-109 ◽  
Author(s):  
Colin R. Rodger ◽  
Allan I. F. Scott ◽  
Lawrence J. Whalley
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
Antidepressant Effect ◽  
Major Depressive ◽  
Depressed Patients ◽  
Severity Of Depression ◽  
Drug Free ◽  
Hamilton Rating Scale

The severity of depression in 11 drug-free unipolar patients diagnosed with definite major depressive disorder was assessed using the Hamilton Rating Scale for Depression during a course (5–10 treatments) of bilateral electroconvulsive therapy (ECT). The degree of improvement after three treatments of ECT was six times greater than the improvement that occurred over the remainder of the course. Although depressed patients who recover with ECT require repeated treatments, the treatments early in a course of ECT can have marked antidepressant effect.

Validity of the Hamilton Rating Scale for Depression

1977 ◽  
Vol 131 (1) ◽  
pp. 49-52 ◽  
Author(s):  
J. W. Knesevich ◽  
J. T. Biggs ◽  
P.J. Clayton ◽  
V. E. Ziegler
Keyword(s):  
Rating Scale ◽  
Global Rating ◽  
Depressed Patients ◽  
Degrees Of Severity ◽  
Hamilton Rating Scale

SummaryIn 26 depressed patients, a high correlation (0·89) was found between the Hamilton score and a psychiatrist's global rating and between the change (0 · 68) in these ratings during treatment. The Hamilton scale was able to differentiate at the 0·01 level four degrees of severity based on the global rating. Limiting the range of severity measured was found to lower significantly the correlation between the ratings. A prospective examination of a six-item sub-scale of the Hamilton scale developed by Beck and associates failed to confirm its claimed improvement in sensitivity or validity.

scholarly journals Association of Functional Outcome and Post Stroke Depression amongAssociation of Functional Outcome and Post Stroke Depression among Stroke Survivor after Three Months Onset: A Preliminary Study

2019 ◽  
Vol 14 (1) ◽  
pp. 31
Author(s):  
Fitria Handayani ◽  
Setyowati Setyowati ◽  
Dwi Pudjonarko ◽  
Dian Ratna Sawitri ◽  
Hastaning Sakti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Outcome ◽  
Barthel Index ◽  
Rating Scale ◽  
Stroke Survivor ◽  
Nursing Intervention ◽  
Research Committee ◽  
Post Stroke ◽  
Post Stroke Depression

<p><span>Background </span></p><p><span>The Post Stroke Depression (PSD) prevalence of stroke survivor after three months onset was ranged from 17% to 37%. Depression led to fatigue, low quality of life, severe morbidity, and mortality.<span>  </span>Functional Outcome influence depression on stroke survivor. <span> </span>However, correlation between functional state level and depression among stroke survivor after three months onset has not been established. </span></p><p><span>Objective</span></p><p><span>This study was aimed to investigate the correlation of executive functional outcome and PSD among stroke survivor after three months onset. </span></p><p><span>Method</span></p><p><span>This study was a correlation study. The participants were 44 stroke ischemic patients after three months onset. Participants were recruited in an outpatient unit. PSD was measured using <span>The GRID-Hamilton Rating Scale for Depression 17 (GRID-HAMD 17) and </span>Functional Outcome was measured using <span>Barthel Index (BI). The reliability of GRID-HAMD 17 was .776. <span> </span>Both instruments were conducted on backward translation in to bahasa. Data was examined using </span>simple linier regression analyses. <span> </span>The ethical approval was obtained from the Ethical Research Committee of the Medical Faculty Diponegoro University and Tugurejo Semarang Hospital. </span></p><p><span>Results</span></p><p><span>The presence of PSD were 56.82. The median of HAMD-GRID-17 was 10.38 ± 7.58, and Barthel Index was 69.56 ± 21.69.<span>  </span>The Barthel Index showed positive correlation with HAMD-GRID-17 (?= -.41 ?=.006). The Functional Outcome determined PSD as much as 16.8 %. </span></p><p><span>Conclusion</span></p><p><span>Moderate association demonstrated the correlation between Functional Outcome and PSD. Nursing intervention should consider these two variables for an optimum quality of life among stroke survivors. </span></p><p> </p>

scholarly journals The Effect of Prenatal Massage Towards Anxiety Level of Third Trimester Pregnant Women in The Work Area Of Cibeureum Public Health Center Tasikmalaya 2019

2020 ◽  
Vol 2 (1) ◽  
pp. 28-30 ◽  
Author(s):  
Eva Ardianti ◽  
Sinar Pertiwi ◽  
Etin Rohmatin
Keyword(s):  
Pregnant Women ◽  
Rating Scale ◽  
Negative Impact ◽  
Sampling Technique ◽  
Data Retrieval ◽  
Anxiety Level ◽  
Third Trimester ◽  
Uterine Muscle ◽  
Work Area ◽  
Hamilton Rating Scale

Background: During pregnancy, most women experience psychological and emotional changes, it often comes up in the third trimester. Anxiety itself will have a negative impact on pregnant women to delivery, such as the fetal nervous and hindering growth, weakens the uterine muscle contraction, and others. One way to overcome anxiety in pregnancy with non-farmokologi method is prenatal massage.Methods: The study design used was pre-experimental research design with one group pretest posttest. Sampling in this research using purposive sampling technique with a sample size of 30 people. Pretest and posttest data retrieval using a measuring instrument HARS Scale (Hamilton Rating Scale for Anxiety). The data were analyzed using univariate and bivariate using Spearman Correlation Test.Result: Obtained results correlation value 0.769, it shows that the correlation is very strong with 0,000 ρvalue (ρvalue 0.05).Conclusion: Thus prenatal massage was effective to reduced the anxiety level of third trimester pregnant women

scholarly journals Acupuncture Treatments for Post-stroke Depression: A Systematic Review and Network Meta-analysis

2021 ◽  
Author(s):  
Lam Wai Ching ◽  
Hui Juan Li ◽  
Jianwen Guo ◽  
Liang Yao ◽  
Janita Chau ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Rating Scale ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Depression Symptoms ◽  
Post Stroke ◽  
Significant Difference ◽  
Post Stroke Depression ◽  
The Impact

Abstract Background: Depression is one of the most common complications after stroke, with a prevalence of 30-33%. Patients with post-stroke depression (PSD) usually experience anxiety, hopelessness, and insomnia, which have a negative impact on their daily activities and post-stroke rehabilitation. In this review, we aimed to explore the impact of acupuncture in alleviating symptoms of PSD and to evaluate the difference in effectiveness between acupuncture combined with pharmacotherapies and various non-pharmacotherapies in order to provide guides and advice for clinical personnel. Methods: Six databases (Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP Database) and two clinical trials registration platforms were searched from inception to May 2021. Randomized clinical trials (RCTs) comparing needle-based acupuncture with pharmacotherapy, and other non-pharmacotherapy or invalid group were included. Two independent reviewers identified eligible studies. Two reviewers independently abstracted and recorded data into a pre-made form. A Bayesian network meta-analysis (NMA) was conducted to assess and compare different techniques using RStudio 3.6.0. The primary outcome was the change in scores of scales measuring depressive symptoms. The secondary outcomes were changes in serotonin levels and in quality of life. Results: Fifty-nine RCTs were included. The results of this NMA showed that compared with western medicine (WM), acupuncture alone or with repetitive transcranial magnetic stimulation (RTMS), Traditional Chinese medicine (TCM) alone or with WM, were superior for alleviating depression symptoms. Compared to Usual Care, acupuncture alone or plus other therapies could significantly decrease scores of the Hamilton Depression Rating scale. However, there was no significant difference found among acupuncture, WM, TCM with AC plus any of other treatment.Conclusions: The results of this study indicate that acupuncture alone or combined with other therapies appear to be effective in improving depression symptoms of stroke survivors. Moreover, in comparison with WM, acupuncture alone or plus RTMS, TCM, TCM with WM, or WM, were more effective in improving depression symptoms. Also, acupuncture with RTMS seems to be the most effective with the highest probability.

scholarly journals Depressed Mood after Stroke: Predictive Factors at Six Months Follow-Up

2020 ◽  
Vol 17 (24) ◽  
pp. 9542
Author(s):  
Fidel López-Espuela ◽  
Raúl Roncero-Martín ◽  
Maria de la Luz Canal-Macías ◽  
Jose M. Moran ◽  
Vicente Vera ◽  
...  
Keyword(s):  
Rating Scale ◽  
Depression Scale ◽  
Length Of Hospital Stay ◽  
Hamilton Depression Scale ◽  
Modified Rankin Scale ◽  
Cross Sectional ◽  
Post Stroke ◽  
Depression Assessment ◽  
Degree Of Disability ◽  
Post Stroke Depression

We aimed to know the prevalence of post-stroke depression (PSD) in our context, identify the variables that could predict post-stroke depression, by using the Hamilton Depression Rating Scale, occurring within six months after stroke, and identify patients at high risk for PSD. Methods: descriptive, cross-sectional and observational study. We included 173 patients with stroke (transient ischemic attack (TIA) included) and collected sociodemographic and clinical variables. We used the Hamilton Depression Scale (HDS) for depression assessment and Barthel Index and modified Rankin Scale (mRS) for functional assessment. The neurological severity was evaluated by the National Institutes of Health Stroke Scale (NIHSS). Results: 35.5% were women, aged 71.16 (±12.3). Depression was present in 42.2% patients (n = 73) at six months after stroke. The following variables were significantly associated with PSD: diagnosis of previous depression (p = 0.005), the modified Rankin Scale at discharge (p = 0.032) and length of hospital stay (p = 0.012). Conclusion: PSD is highly prevalent after stroke and is associated with the severity, left location of the stroke, and the degree of disability at discharge. Its impact justifies the evaluation and early treatment that still continues to be a challenge today.

scholarly journals Magnitude and determinants of depression in acute stroke patients admitted in a rural tertiary care hospital

2015 ◽  
Vol 6 (02) ◽  
pp. 202-207 ◽  
Author(s):  
Amrish Saxena ◽  
Ajitabh Suman
Keyword(s):  
Acute Stroke ◽  
Rating Scale ◽  
Tertiary Care Hospital ◽  
Economic Status ◽  
Tertiary Care ◽  
Care Hospital ◽  
Stroke Patients ◽  
Post Stroke ◽  
Socio Economic Status ◽  
Post Stroke Depression

ABSTRACT Objectives: Depression is one of the most frequent neuropsychiatric disturbances after a cerebrovascular stroke. The frequency of depression in stroke patients has varied widely in different populations. Post stroke depression is an important factor limiting recovery and rehabilitation in acute stroke patients. Settings and Design: A cross-sectional hospital-based study was performed in acute stroke patients admitted in the department of Medicine of a rural teaching tertiary care hospital in central India. Materials and Methods: In all consecutive acute stroke inpatients, the intensity of depression was assessed by a trained person through a questionnaire, Montgomery-Asberg Depression Rating Scale (MADRS), who is blind of the diagnosis and investigations of the patient. Another study person collected the data including demographics, co-morbid diseases or risk factors. Radiological imaging data was noted from the CT/MRI head reports of stroke patients. Results: Of the total 107 stroke patients, 60 (56%) were males and 47 (44%) were females. Sixty-one (57%) of the 107 stroke patients had depression. Of the 107 stroke patients, 35 (33%) had mild depression, 22 (20%) had moderate depression and 4 (4%) had severe depression. The age, gender, education status and co-morbidities of the stroke patient were not associated with depression. The association of socio-economic status and left-sided lesions with depression was found to be statistically significant (P < 0.05). Type and location of the lesion were not associated with depression. Conclusion: Post-stroke depression was present in more than half of the stroke patients and was related to socio-economic status and left-sided hemisphere lesions.

Personality Neuroticism and Depression after Stroke

1995 ◽  
Vol 25 (1) ◽  
pp. 93-102 ◽  
Author(s):  
Philip L. P. Morris ◽  
Robert G. Robinson
Keyword(s):  
Risk Factor ◽  
Depressive Symptomatology ◽  
Life Time ◽  
Depression Diagnosis ◽  
Post Stroke ◽  
Depressed Patients ◽  
Retrospective Assessment ◽  
Post Stroke Depression ◽  
Severity Of Depression

Aim: The aim of this study was to determine whether personality neuroticism or extroversion traits are associated with post-stroke depression. Method: Ninety-four stroke inpatients undergoing rehabilitation were examined two months post-stroke for the presence and severity of depression and a retrospective assessment was made of life-time neuroticism and extroversion. Results: Depressed patients ( N = 35) had higher neuroticism scores than non-depressed patients. Neuroticism was correlated positively with depressive symptomatology. Extroversion was not associated with depression diagnosis or depressive symptomatology. Conclusion: We conclude that personality neuroticism may be a risk factor for depression following stroke.

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