Research reportDepressive symptoms in stroke patients: A 13 month follow-up study of patients referred to a rehabilitation unit
Section snippets
Subjects
The study sample consists of 194 patients diagnosed with an ischaemic or a hemorrhagic stroke through clinical examination and/or computed tomography (CT), consecutively recruited at a mean of 18.3 days (SD 13.4) after admission to the Stroke Rehabilitation Unit at Ullevaal University Hospital, Oslo, Norway, between March 2005 and August 2006. Mean age (and standard deviation, s.d.) was 76.9 (10.5) years; 95 (49%) were women. Mean age for women was 79.4 (9.6) years, for men 74.5 (10.9) years.
Pre-stroke information and medical history
Pre-stroke cognitive function was assessed by the Norwegian version of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). The IQCODE is a structured questionnaire consisting of 26 items assessing cognitive changes suffered by an informant over the past 10 years. It has been widely used for the screening of dementia (Jorm, 2004). A score above three indicates a decline in cognition.
Functioning in the activities of daily living (ADL) was assessed with the Barthel ADL Index
Results
The mean age of the 126 patients followed up at 13 months was 75.0 (s.d 11.3) years; 58 (46%) were women. The mean age of the women was 78.8 (s.d 9.9) years, whereas the mean age of the men was 74.8 (s.d. 11.2) years.
Discussion
The prevalence of clinically significant depressive symptoms defined as a score on MADRS above six was relatively unchanged from baseline (56%) to the 13 month follow-up stage (48%). We found a relatively high prevalence of depression, but still within the 18% to 61% prevalence range described in two systematic reviews (Aben et al., 2001, House, 1987). Differences in diagnostic methods, time of assessment and subject samples may explain the general discrepancy between post-stroke prevalence
Role of funding source
Funding for this study was provided by the Eastern Norway Regional Health Authority and Norwegian Centre for Dementia Research, Centre for Ageing and Health; they had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.
Lasse Farner (sign).
Conflict of interest
All authors declare that they have no conflicts of interest.
Acknowledgements
Authors thank Eastern Norway Regional Health Authority and Norwegian Centre for Dementia Research, Centre for Ageing and Health for their financial support.
References (57)
- et al.
Research into the specificity of depression after stroke: a review on an unresolved issue
Progress in Neuro-Psychopharmacology & Biological Psychiatry
(2001) - et al.
“Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician
Journal of Psychiatric Research
(1975) Long-term prognosis after lacunar infarction
Lancet Neurology
(2003)Poststroke depression: prevalence, diagnosis, treatment, and disease progression
Biological Psychiatry
(2003)- et al.
Post stroke depression: epidemiology, pathophysiology, and biological treatment
Biological Psychiatry
(2002) - et al.
Personality and vulnerability to depression in stroke patients — a 1-year prospective follow-up study
Stroke
(2002) - et al.
Risk factors for post-stroke depression
Acta Psychiatrica Scandinavica
(1995) - et al.
Incidence of post-stroke depression during the first year in a large unselected stroke population determined using a valid standardized rating scale
Acta Psychiatrica Scandinavica
(1994) - et al.
Poor outcome after first-ever stroke: predictors for death, dependency, and recurrent stroke within the first year
Stroke
(2003) - et al.
Major depression in stroke patients — a 3-year longitudinal-study
Stroke
(1993)