medigraphic.com
ISSN 2225-4676 (Electronic)

2012, Number 1

<< Back Next >>

Rev Cubana Neurol Neurocir 2012; 2 (1)

Post–stroke depression: frequency and determinants

Fernández CO, Marrero FM, Mesa BY, Santiesteban VN, Rojas FJ

Language: Spanish
References: 44
Page: 9-16
PDF size: 265.47 Kb.


ABSTRACT

Objective: Determine the frequency of post–stroke depression (PSD) and identified factors those explain it.
Methods: We studied 120 stroke survivors who were classified according to Geriatric Depression Scale (GDS) as: without depression (GDS ‹ 5), with depressive symptoms (GDS 5–9), and PSD (GDS ≥ 10). To defined factors associated to PSD we included some variables (demographics, comorbidity and toxic habits, disease–related and disease–consequences variables). We used bivariate and multivariate statistical methods (regression logistic).
Results: 76% of patients presented depressive symptoms and 33% PSD. Frontal lobe affectation (43% vs. 19%) and disability (42% versus 14%) were associated with DPI in bivariate analysis but lose their effect in multivariate analysis. Regression logistic model showed that cognitive impairment (OR: 2.6; IC 95%: 1.02–6.72) and degree of neurological impairments (OR: 0.20; IC 95%: 0.04–0.86 between severe and moderate and OR: 0.22; IC 95%: 0.07–0.65 between moderate and light) were factors whose independently explain the presence of PSD.
Conclusions: One third of stroke survivors have PSD. Factors which explain PSD were: degree of neurological impairment and presence of cognitive impairment.


REFERENCES

  1. Mackay J, Mensah GA. Deaths from stroke. In: The Atlas of Heart Disease and Stroke. World Health Organization. WHOLIS [base de datos en Internet]. [citado 6.02.2010]; Disponible en: http://whqlibdoc.who.int/publications/2004/9241562768.pdf

  2. Buergo Zuáznabar MA, Fernández Concepción O, Coutín MG, Torres RM. Epidemiology of Cerebrovascular Diseases in Cuba, 1970 to 2006. MEDICC Review. 2008;10:33–8.

  3. Haacke C, Althaus A, Spottke A, Siebert U, Back T, Dodel R. Long–term outcome after stroke: evaluating health– related quality of life using utility measurements. Stroke. 2006;37:193–8.

  4. Hackett ML, Yapa C, Parag V, Anderson CS. Frequency of depression after stroke: a systematic review of observational studies. Stroke. 2005;36:1330–40.

  5. Herrmann N, Black SE, Lawrence J, Szekely C, Szalai JP. The Sunnybrook Stroke Study: a prospective study of depressive symptoms and functional outcome. Stroke. 1998;29:618–24.

  6. Pohjasvaara T, Vataja R, Leppa¨vuori A, Kaste M, Erkinjuntti T. Depression is an independent predictor of poor long–term functional outcome post–stroke. Eur J Neurol. 2001;8:315–9.

  7. Jaracz K, Jaracz J, Kozubski W, Rybakowski JK. Post– stroke quality of life and depression. Acta Neuropsych Scan. 2002;14:219–25.

  8. Stenager EN, Madsen C, Stenager E, Boldsen J. Suicide in patients with stroke: epidemiological study. BMJ. 1998;316:1206.

  9. Eriksson M, Asplund K, Glader EL, Norrving B, Stegmayr B, Terént A, et al; Risk–Stroke Collaboration. Self– reported depression and use of antidepressants after stroke: a national survey. Stroke. 2004;35:936–41.

  10. Morris PLP, Robinson RG, Andrzejewski P, Samules J, Price TR. Association of depression with 10–year poststroke mortality. Am J Psychiatry. 1993;150:124–9.

  11. Williams LS, Ghose S, Swindle RW. The effect of depression and other mental health diagnoses on mortality after ischemic stroke. Am J Psychiatry. 2004;161:1090–5.

  12. Ghose S, Williams LS, Swindle R. Depression and other mental health diagnoses after stroke increase inpatient and outpatient medical utilization 3 years post–stroke. Med Care. 2005;43:1259–64.

  13. Carnwath TCM, Johnson DAW. Psychiatric morbidity among spouses of patients with stroke. BMJ. 1987;294:409–11.

  14. Tompkins CA, Schulz R, Rau MT. Post–stroke depression in primary support persons: predicting those at risk. J Consult Clin Psychol. 1988;56:502–8.

  15. Anderson CS, Linto J, Stewart–Wynne EG. A population based assessment of the impact and burden of caregiving for long–term stroke survivors. Stroke. 1995;26:843–9.

  16. Dennis M, O’Rourke S, Lewis S, Sharpe M, Warlow C. A quantitative study of the emotional outcome of people caring for stroke survivors. Stroke. 1998;29:1867–72.

  17. Greveson GC, Gray CS, French JM, James OFW. Longterm outcome for patients and carers following hospital admission for stroke. Age Ageing. 1991;20:337– 44.

  18. Robinson RG, Kubos KL, Starr LB, Rao K, Price TR. Mood changes in stroke patients: importance of lesion location. Brain. 1984;107:81–93.

  19. Robinson RG, Szetela B. Mood change following left hemispheric brain injury. Ann Neurol. 1981;9:447–53.

  20. Vataja R, Leppavuori A, Pohjasvaara T, et al. Poststroke depression and lesion location revisited. J Neuropsychiatry Clin Neurosci. 2004;16:156–62.

  21. Carson AJ, MacHale S, Allen K, Lawrie SM, Dennis M, House A.. Depression after stroke and lesion location: a systematic review. Lancet. 2000;356:122–6.

  22. Narushima K, Kosier JT, Robinson RG. A reappraisal of poststroke depression, intra– and inter–hemispheric lesion location using meta–analysis. J Neuropsychiatry Clin Neurosci. 2003;15:422–30.

  23. Naess H, Nyland HI, Thomassen L, Aarseth J, Myhr KM. Mild depression in young adults with cerebral infarction at long–term follow–up: a population–based study. Eur J Neurol. 2005;12:194–8.

  24. Burvill P, Johnson G, Jamrozik K, Anderson C, Stewart– Wynne E. Risk factors for post–stroke depression. Int J Geriatr Psychiatry. 1997;12:219–26.

  25. Sharpe M, Hawton K, Seagroatt V, Bamford J, House A, Molyneux A. Depressive disorders in long–term survivors of stroke: associates with demographic and social factors, functional status, and brain lesion volume. Br J Psychiatry. 1994; 164:380–6.

  26. Williams LS. Depression and Stroke: Cause or Consequence? Sem Neurol. 2005;25:396–409.

  27. Ouimet MA, Primeau F, Cole MG. Psychosocial risk factors in poststroke depression: a systematic review. Can J Psychiatry. 2001;46:819–28.

  28. Fernández-Concepción O, Rojas-Fuentes J, Pando A, Marrero-Fleita M, Mesa-Barrero Y, Santiesteban- Velázquez N, et al. Deterioro cognitivo después de un infarto cerebral: frecuencia y factores determinantes. Rev Neurol. 2008;46:326–30.

  29. Burvill PW, Johnson GA, Jamrozik KD, Anderson CS, Stewart–Wynne EG, Chakera TM. Prevalence of depression after stroke: the Perth Community Stroke Study. Br J Psychiatry. 1995;166:32–07

  30. Wade DT, Leigh–Smith J, Hewer RA. Depressed mood after stroke. A community study of its frequency. Br J Psychiatry. 1987;151:200–5.

  31. Robinson RG, Bolduc PL, Price TR. A two year longitudinal study of poststroke mood disorders: diagnosis and outcome at one and two years. Stroke. 1987;18:837– 43.

  32. Diller L, Bishop DS. Depression and stroke. Top Stroke Rehabil. 1995;2:44–55.

  33. Carod–Artal FJ. Depresión postictus (I). Epidemiología, criterios diagnósticos y factores de riesgo. Rev Neurol. 2006;42:169–75.

  34. Tang WK, Chan SSM, Chiu HFK, Wong KS, Kwok TCY, Mok V, et al. Can the Geriatric Depression Scale detect poststroke depression in Chinese elderly? J Affect Disord. 2004;81:153–6.

  35. Robinson RG, Starr LB, Lipsey JR, Rao K, Price TR. A two–year longitudinal study of post–stroke mood disorders: dynamic changes in associated variables over the first six months of follow–up. Stroke. 1984;15:510–7.

  36. Singh A, Black SE, Herrmann N, Leibovitch FS, Ebert PL, Lawrence J, et al. Functional and neuroanatomic correlations in poststroke depression. The Sunnybrook Stroke Study. Stroke. 2000;31:637–44.

  37. Carod–Artal FJ, González–Gutiérrez JL, Egido–Herrero JA, Varela de Seijas E. Depresión postictus: factores predictivos al año de seguimiento. Rev Neurol. 2002;35:101–6.

  38. Berg A, Palomaki H, Lehtihalmes M, Lonnqvist J, Kaste M. Poststroke depression in acute phase after stroke. Cerebrovasc Dis. 2001;12:14–20.

  39. Narushima K, Chan KL, Kosier JT, Robinson RG. Does cognitive recovery after treatment of poststroke depression last? A 2–year followup of cognitive function associated with poststroke depression. Am J Psychiatry. 2003;160:1157–62.

  40. Hackett ML, Anderson CS, House AO. Interventions for treating depression after stroke. Cochrane Database Syst Rev. 2004;(3):CD003437.

  41. Williams LS, Kroenke K, Bakas T, Plue LD, Brizendine E, Tu W, et al. Care Management of Poststroke Depression: A Randomized, Controlled Trial. Stroke. 2007;38:998– 1003.

  42. Parikh RM, Robinson RG, Lipsey JR, Starskein SE, Fedoroff JP, Price TR. The impact of poststroke depression on recovery in activities of daily living over a 2 year followup. Arch Neurol. 1990;47:785–9.

  43. Robinson RG. Neuropsychiatric consequences of stroke. Annu Rev Med. 1997;48:217–29.

  44. Fernández-Concepción O, Ramírez-Pérez E, Álvarez MA, Buergo-Zuáznabar MA. Validación de la escala de calidad de vida para el ictus (ECVI–38). Rev Neurol. 2008;46:147– 52.




2020     |     www.medigraphic.com