Post stroke depression: risk factors and potential effects on functional recovery

2017 ◽  
Vol 27 (8) ◽  
pp. 13-13
Author(s):  
Kathy Davis
Keyword(s):  
Risk Factors ◽  
Functional Recovery ◽  
Post Stroke ◽  
Depression Risk ◽  
Post Stroke Depression

Benefits of antidepressant treatment after a stroke

2017 ◽  
Vol 41 (S1) ◽  
pp. S315-S315 ◽  
Author(s):  
O. Zerriaa ◽  
O. Moula ◽  
S. Ben Saadi ◽  
I. Jelalia ◽  
R. Ghachem
Keyword(s):  
Functional Recovery ◽  
Cognitive Skills ◽  
Antidepressant Treatment ◽  
Antidepressant Drugs ◽  
Antidepressant Therapy ◽  
Motor Deficit ◽  
Stroke Patients ◽  
Double Blind ◽  
Post Stroke ◽  
Post Stroke Depression

IntroductionStroke is an important cause of morbidity and is responsible for 9% of all deaths worldwide. The most frequent neuropsychiatric consequence of stroke is post-stroke depression (PSD). It has been shown to be associated with both impaired recovery and increased mortality. The aim of our study is to determine the benefits of antidepressant prescription after a stroke.MethodThe databases from Medline and PubMed were reviewed for articles related to post-stroke depression (PSD), antidepressant treatment and stroke, post-stroke depression and functional recovery, stroke related impairment.ResultsAntidepressant drugs have been shown to be effective in treating PSD in six double blind randomized studies. Patients treated with antidepressants had better recovery from disability than patients who did not receive antidepressant therapy: it was proved that antidepressant drugs cause an improvement in cognitive skills and functional recovery in PSD patients. In patients with ischemic stroke and moderate to severe motor deficit, the early prescription of fluoxetine with physiotherapy enhanced motor recovery after 3 months. Some studies showed that PSD can be effectively prevented: nortriptyline, fluoxetine, milnacipran and sertraline appeared to be efficacious in preventing depression after stroke and are to use without significant adverse effects in stroke patients.ConclusionAntidepressant treatment plays an increasing role in the management of patients with acute stroke. Therefore, early initiation of antidepressant therapy, in non-depressed stroke patients, may reduce the odds for development of PSD, and improve cognitive and functional recovery.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Socio-Demographic Characteristics of the Patients with a Post Stroke Depression from the Municipality of Tetovo, Republic of Macedonia

2018 ◽  
Vol 6 (5) ◽  
pp. 782-785 ◽  
Author(s):  
Danijela Vojtikiv-Samoilovska ◽  
Anita Arsovska
Keyword(s):  
Risk Factors ◽  
Occupational Status ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Demographic Characteristics ◽  
Depression Symptoms ◽  
Post Stroke ◽  
Republic Of Macedonia ◽  
Significant Dependence ◽  
Post Stroke Depression

BACKGROUND: Although post-stroke depression (PSD) is the most common neuro-psychiatric consequence after a stroke there is still some obscurity regarding its aetiology and risk factors, which complicates its management. A better knowledge of the predictors will enable better prevention and treatment.AIM: The aim of this work was the identification of the risk factors for PSD, typical for the Macedonian population, which will help in early prediction, timely diagnosis and treatment of the disease.MATERIALS AND METHODS:  We carried out a prospective study at the Clinical Hospital in Tetovo, the Republic of Macedonia to determine the prevalence of PSD and to analyse the socio-demographic characteristics as possible risk factors in 100 patients on discharge and after 5 months. The depression symptoms were quantified using the Hamilton Depression Ranking Scale (HAM-d) and the Geriatric Depression Scale (GDS).RESULTS: The average age of the patients with PSD on the first examination is 65.0 ± 8.3, whereas on the second examination is 64.5 ± 9.2. According to the Mann-Whitney U test, the difference between the average ages on both examinations is statistically insignificant for p > 0.05. On both examinations, the statistically significant dependence of p > 0.05 between PSD and the occupational status and PSD and education is not recorded. On both examinations, the PSD in male patients was 78.0% and 62.7%, while in female patients it was 85.4% and 68.3% not recording the statistically significant dependence of p < 0.05 between PSD and the gender.CONCLUSION: The socio-demographic characteristics of the patients with PSD cannot be considered as predictors of the disease.

Abstract WMP98: Post-Stroke Depression Predictors Among Intracerebral Hemorrhage Survivors

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Radhika Avadhani ◽  
Richard E Thompson ◽  
Nichol McBee ◽  
Noeleen Ostapkovich ◽  
Lourdes Carhuapoma ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Intracerebral Hemorrhage ◽  
Functional Recovery ◽  
Right Hemisphere ◽  
Depression Scale ◽  
Multivariable Logistic Regression Analysis ◽  
Clinical Predictors ◽  
Post Stroke ◽  
Patient Disposition ◽  
Post Stroke Depression

Introduction: Post-stroke depression (PSD) in ischemic stroke is well-documented in the literature, but much less in intracerebral hemorrhage (ICH). We aimed to evaluate the clinical predictors of PSD in a cohort of ICH patients. Methods: 499 randomized ICH subjects in MISTIE-III trial were followed for 1 year. Center for Epidemiologic Studies Depression Scale (CES-D) was assessed at 180 days (D180) post-ICH. A score of CES-D ≥16 were considered depressed. 300 out of 379 survivors responded. Multivariable logistic regression analysis was performed to identify independent predictors of depression at D180 with adjustment for baseline demographic characteristics, ICH hemisphere and severity, and functional recovery, cognition status and patient disposition at day 30 (Model 1) and day 180 (Model 2). Good functional outcome was defined as modified Rankin Scale (mRS) 0-3 vs. 4-5 (poor mRS), cognitive impairment status was defined as screening Mini-Mental State Examination (MMSE) < 24 and good patient disposition was defined as patient location at home. Prior use of antidepressants was too small to consider. Results: Using CES-D, 106/300 subjects (35%) were considered depressed at day 180. Both models found that female gender, Hispanic ethnicity, and right hemisphere ICH location were statistically significant predictors of PSD. Poor mRS at D180 was statistically significant D180. Early (D30), but not late cognitive impairment was also significant. Conclusion: Almost 4 out of 10 ICH survivors displayed significant depression as defined by CES-D. Race/ethnicity, gender, ICH hemisphere, and poor functional recovery appear to influence post-stroke depression, while later cognitive impairment, volumetric, age, and later home location were less important.

RISK FACTORS FOR POST-STROKE DEPRESSION

1997 ◽  
Vol 12 (2) ◽  
pp. 219-226 ◽  
Author(s):  
PETER BURVILL ◽  
GLORIA JOHNSON ◽  
KONRAD JAMROZIK ◽  
CRAIG ANDERSON ◽  
EDWARD STEWART-WYNNE
Keyword(s):  
Risk Factors ◽  
Post Stroke ◽  
Post Stroke Depression

Focal or generalized vascular brain damage and vulnerability to depression after stroke: a 1-year prospective follow-up study

2006 ◽  
Vol 18 (1) ◽  
pp. 19-35 ◽  
Author(s):  
I. Aben ◽  
J. Lodder ◽  
A. Honig ◽  
R. Lousberg ◽  
A. Boreas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Damage ◽  
Rating Scales ◽  
Screening Tools ◽  
Vascular Depression ◽  
Lesion Location ◽  
Post Stroke ◽  
Negative Results ◽  
Post Stroke Depression ◽  
One Year

Background: Both the lesion location hypothesis and the vascular depression hypothesis have been proposed to explain the high incidence of depression in stroke patients. However, research studying both hypotheses in a single cohort is, at present, scarce.Objective: To test the independent effects of lesion location (left hemisphere, anterior region) and of co-occurring generalized vascular damage on the development of depression in the first year after ischemic stroke, while other risk factors for depression are controlled for.Methods: One hundred and ninety consecutive patients with a first-ever, supratentorial infarct were followed up for one year. CT was performed in the acute phase of stroke, while in 75 patients an additional MRI scan was also available. Depression was assessed at 1, 3, 6, 9, and 12 months after stroke using self-rating scales as screening tools and the SCID-I to diagnose depression according to DSM-IV criteria.Results: Separate analyses of the lesion location hypothesis and the vascular depression hypothesis failed to reveal significant support for either of these biological models of post-stroke depression. Similar negative results appeared from one overall, multivariate analysis including variables of both focal and generalized vascular brain damage, as well as other non-cerebral risk factors. In addition, level of handicap and neuroticism were independent predictors of depression in this cohort, as has been reported previously.Conclusion: This study supports neither the lesion location nor the vascular depression hypothesis of post-stroke depression. A biopsychosocial model including both premorbid (prior to stroke) vulnerability factors, such as neuroticism and (family) history of depression, as well as post-stroke stressors, such as level of handicap, may be more appropriate and deserves further study.

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