Depression Improvement Is Related to Social Role Functioning After Stroke

Objectives: To (1) examine the relationships between baseline demographic, clinical, and psychological characteristics and social role functioning (SRF) at 4 months after stroke, and (2) assess whether depression improvement is associated with 4-month SRF. Design: We completed a secondary data analysis using data from a completed cohort study including people with stroke with or without depression. We used multiple linear regression to identify variables independently associated with 12-week SRF. Setting: Hospital and patients' homes. The intervention was via phone calls. Participants: People with a new stroke recruited during the inpatient stay (N=371, depressed only n=176). All survived an ischemic stroke, were 18 years and older, spoke and understood English, owned a telephone, had no severe language or cognitive impairments, and were expected to live at least 6 months. Interventions: Not applicable. Main Outcome Measures: We measured depression with the Patient Health Questionnaire-9 (PHQ-9), and depression improvement was defined by a 50% decrease in PHQ-9 scores from baseline to 12 weeks or a 12-week PHQ-9 score <10. SRF was measured with the social domain of the Stroke-Specific Quality of Life Scale. Results: Depression and comorbidities were found to be independently associated with 12-week SRF. Importantly, depression response (or depression improvement) was the only variable to independently predict SRF in the depressed-only group. Conclusions: Among stroke survivors with depression, improvement of that depression was independently associated with improved SRF. This is a reminder of the importance for rehabilitation providers to screen for and treat poststroke depression. (c) 2012 by the American Congress of Rehabilitation Medicine