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

Author(s):  
Fidel López-Espuela ◽  
Raúl Roncero-Martín ◽  
Maria de la Luz Canal-Macías ◽  
Jose M. Moran ◽  
Vicente Vera ◽  
...  

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.

Author(s):  
Gurumayum Sonachand Sharma ◽  
Anupam Gupta ◽  
Meeka Khanna ◽  
Naveen Bangarpet Prakash

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.


2016 ◽  
Vol 40 (3-4) ◽  
pp. 420-430 ◽  
Author(s):  
Ling Zhang ◽  
Rubo Sui ◽  
Lei Zhang ◽  
Zhuang Zhang

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.


2021 ◽  
Author(s):  
Yihui Zhang ◽  
Zekun Xing ◽  
Zhanxiang Xie ◽  
Yuzheng Zhou ◽  
Shengjie Wan ◽  
...  

Abstract Background: Post-stroke depression(PSD) lacks timely and effective treatment and virtual reality (VR) technology can create a lifelike experience and simulate users' physical presence in an immersive environment. It has been confirmed to have a positive effect on stroke and depression. Data about the efficacy VR on PSD are limited. The intensification of fibroblast growth factor 21(FGF21) can improve depression and other emotional symptoms, but there is no study on its role in PSD.Methods: We enlisted 76 PSD patients (6 lost) and divided into the experimental group and control group randomly. The patient underwent psychological rehabilitation once a week for 50 minutes each time for a total of 12 weeks. The patients in the experimental group received psychological counseling and VR rehabilitation while patients in the control group also took the same pattern but without VR rehabilitation. The Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were evaluated before rehabilitation, in the 4th week and at the end of rehabilitation respectively in two groups for the sake of observing changes in the patients' depression. Then 8 people in each group did functional near-infrared spectroscopy (fNIRS), and blood samples were taken for detection with brain-derived neurotrophic factor (BDNF), IL-6, TNF-α and FGF21 by ELISA.Results: The result of fNIRS showed the hemodynamic activation in the prefrontal region of the experimental group was significantly increased. Both groups of FGF21 increased and compared with the control group, the experimental group has a greater upsurge and a faster increase rate.Conclusions: VR alleviates PSD. FGF21 is closely related to PSD,and it is likely to be a potential pathological mechanism of PSD. It suggests that VR is possible to improve PSD by increasing FGF21.Trial registration: We registered in Chinese Clinical Trial Registry which is the first level registration organization of WHO international clinical trial registration platform. The registration number is ChiCTR1900027987, the date of registration December 7, 2019.


2021 ◽  
Vol 12 ◽  
Author(s):  
Ya-Ying Zeng ◽  
Meng-Xuan Wu ◽  
Dan-Dan Geng ◽  
Lin Cheng ◽  
Sheng-Nan Zhou ◽  
...  

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.


2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yewei Qu ◽  
Lu Zhang ◽  
Dongfang Shen ◽  
Wangzikang Zhang ◽  
Mingsha Zhang ◽  
...  

Objectives. We aimed to investigate the prevalence of restless leg syndrome (RLS) and exploring the contributing factors that affect the development of RLS in Parkinson’s disease (PD) patients. Methods. A cross-sectional study was conducted consisting of 178 consecutive PD patients from our hospital between October 2015 and August 2016. We divided the participants into two groups, which were PD with RLS and PD with non-RLS. Then, we recorded their demographics and clinical data to draw a comparison between PD with RLS and PD with non-RLS. Results. 23 (12.92%) were diagnosed with RLS among all the enrolled PD patients. Unified Parkinson’s Disease Rating Scale III (UPDRS III) and Hamilton Depression Scale (HAMD) scores, probable rapid eye movement sleep behavior disorder (PRBD), and daily levodopa equivalent dose (LED) in the PD with the RLS group were significantly different from those in the PD with the non-RLS group. Daily LED and the scores of UPDRS III and HAMD in PD patients with RLS were all higher than those in PD patients with non-RLS. PRBD, daily LED, and HAMD scores were significantly independent factors contributing to the development of RLS (OR=4.678, 95% CI 1.372~15.944, P=0.014; OR=1.003, 95% CI 1.001~1.005, P=0.019; OR=1.094, 95% CI 1.002~1.193, P=0.045). The severity of RLS was positively correlated with the duration of PD and daily LED (r=0.438, P=0.036; r=0.637, P=0.001). Conclusion. PRBD existence, daily LED, and HAMD scores are independent factors for developing RLS in PD patients. PRBD existence is firstly proposed as an independent factor in developing RLS among PD patients. RLS severity in PD patients are positively associated with the duration of PD and daily LED.


2020 ◽  
Vol 6 (1) ◽  
pp. 57-65
Author(s):  
Somayeh Shokrgozar ◽  
◽  
Maryam Alizade Nia ◽  
Robabeh Soleimani ◽  
Mahnaz Fallahi Kheshtmasjedi ◽  
...  

Background: Psychiatrists use different scales to evaluate post-stroke depression; however, some concerns have raised about their low specificity. Objectives: This study aimed to assess the validity and reliability of the Persian version of the Post-Stroke Depression Scale (PSDS) in Iran. Materials & Methods: In this analytical cross-sectional study, 155 patients with stroke who were referred to neurology clinics in Rasht City, Iran, were interviewed by a psychiatric assistant (Gold Standard DSM-5 interview was used to separate the depressed from the non-depressed). The participants were then assessed by the PSDS and the hospital anxiety and depression scale (HADS). Moreover, a Receiver Operating Characteristic (ROC) curve with the standard Gold DSM-5 interview was used to determine the ability of the scales and to categorize depression. Eventually, the data were analyzed in SPSS v. 19. Results: Data analysis indicates that the factor structure of HADS is one-dimensional, and exploratory and confirmatory analysis supported the fit for the one-factor model as the best fitting model. Bartlett test (The Chi-square=408.217, df=28, P<0.001) showed significant relationships between variables. The internal consistency of HADS was 0.638 for depression and 0.617 for anxiety. The test-retest reliability is equal to for 60 subjects were randomly re-evaluated within one to two weeks, reported that r=0.783, for anxiety and r=0.741 for depression. Finally, based on the ROC curve, the cut-off point of 9 was chosen, and the different severity of depression was distinguished by 9, 14, and 20. Conclusion: The Persian version of PSDS possesses appropriate psychometric properties among the Iranian population.


2016 ◽  
Vol 74 (8) ◽  
pp. 621-625 ◽  
Author(s):  
Emanuella Barros dos Santos ◽  
Rosalina Aparecida Partezani Rodrigues ◽  
Octávio Marques Pontes-Neto

ABSTRACT Objective To identify the prevalence of post stroke depression (PSD) and their socio-demographic and clinical predictors among elderly stroke survivors after hospital discharge to home. Methods In this cross-sectional study, 90 elderly stroke survivors were evaluated 14 days after hospital discharge with the following scales: National Institutes of Health Stroke Scale, Functional Independence Measure, and Geriatric Depression Scale – 15 items (GDS-15). PSD was defined as a score > 5 on GDS-15. After univariate analyses, a multivariate logistic regression model was built to identify independent predictors of PSD. Results Fourteen days after hospital discharge, 27.7% (95%CI 18.1 to 37.2) of elderly stroke survivors had PSD. Functional dependence was the only independent predictor of PSD (OR: 1.04 95%CI: 1.01 to 1.09; p = 0.02). Conclusion After stroke, depressive symptoms are common among elderly survivors. The degree of functional dependency is the main predictor of PSD among elderly stroke patients in Brazil.


Author(s):  
Małgorzata Paprocka-Borowicz ◽  
Mona Wiatr ◽  
Maria Ciałowicz ◽  
Wojciech Borowicz ◽  
Agnieszka Kaczmarek ◽  
...  

Stroke is a high-risk factor for depression. Neurological rehabilitation is greatly difficult and often does not include treatment of depression. The post-stroke depression plays an important role in the progress of treatment, health, and the life of the patient. The appropriate treatment of depression could improve the quality of life of the patient and their family. The study aimed to evaluate the impact of physical activity and socio-economic status of the patient on the effectiveness of recovery from depression and the severity of the symptoms of depression. The study was conducted with 40 patients after stroke aged 42–82 years, and included 10 women and 30 men who were hospitalized for two weeks. The severity of depression/anxiety (D/A) symptoms were evaluated two times; at admission and after two weeks of physical therapy. The hospital anxiety and depression scale (HADS) questionnaire was used for this purpose. Socio-economic status was evaluated by several simple questions. It was revealed that physical therapy has a positive influence on mental state. The severity of D/A symptoms after stroke is related to the financial status of the patients (2 = 11.198, p = 0.024). The state of health (2 = 20.57, p = 0.022) and physical fitness (2 = 12.95, p = 0.044) changed the severity of symptoms of anxiety and depressive disorders. The kinesiotherapy in the group of patients with post-stroke depression had positive effects; however, economic and health conditions may influence the prognosis of the disease.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
He-Yang You ◽  
Lei Wu ◽  
Hai-Ting Yang ◽  
Chen Yang ◽  
Xiao-Ling Ding

Background. Pain is frequent in Parkinson’s disease (PD) and Parkinson-plus syndrome. This study aimed to assess the prevalence, characteristics, therapy (especially the effect of dopaminergic therapy), and associated symptoms of pain in Parkinson's disease and multiple system atrophy (MSA) patients. Methods. Seventy-one PD patients, sixty-five MSA patients, and forty age-matched healthy controls were enrolled and evaluated by using the German pain questionnaire and visual analogue scale (VAS). In addition, the influence of pain in PD patients on anxiety, depression, and the quality of life was assessed with the Hospital Anxiety and Depression Scale (HADS) and Parkinson’s Disease Questionnaire (PDQ-39). Results. Compared to that of the healthy controls, the PD and MSA patients had a significantly higher presence of pain (P<0.01, P<0.01). PD patients had a higher presence of pain than MSA patients (P=0.007). No difference in VAS scores was observed between the PD and MSA patients (P=0.148). A total of 21 PD patients (42.85%) with pain and 13 MSA patients (43.33%) with pain received treatment. A total of 13 PD patients with pain and 6 MSA patients with pain had an improved pain intensity after using dopaminergic medication. The differences in the disease duration, Hoehn and Yahr stages, and scores on the Unified Parkinson’s Disease Rating Scale motor score, HAD-D, HAD-A, and PDQ-39 were significant between the PD patients with and without pain. Conclusion. PD and MSA patients are prone to pain with insufficient treatment. Pain interventions should be provided as soon as possible to improve the patient’s life.


Sign in / Sign up

Export Citation Format

Share Document