Depression after minor stroke: prevalence and predictors

被引:81
作者
Altieri, M. [1 ]
Maestrini, I. [1 ]
Mercurio, A. [1 ]
Troisi, P. [1 ]
Sgarlata, E. [1 ]
Rea, V. [1 ]
Di Piero, V. [1 ]
Lenzi, G. L. [1 ]
机构
[1] Dept Neurol & Psychiat, Clin Neurol A, I-00185 Rome, Italy
关键词
post-stroke depression; dysthymia; minor stroke; depressive symptoms; risk factors; POSTSTROKE DEPRESSION; DEMENTIA; SYMPTOMS;
D O I
10.1111/j.1468-1331.2011.03583.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and purpose: Post-stroke depression (PSD) is one of the most frequent complications of stroke, with a prevalence ranging 2060%. As PSD seems to be related to stroke severity, we hypothesized that the prevalence of PSD would be lower in patients with minor stroke. Methods: We investigated the prevalence and predictors of PSD over a 30-month follow-up period in a cohort of patients with minor ischaemic stroke (NIHSS <= 5). Results: We enrolled 105 patients (mean age 64.38 +/- 11.2 years, M/ F 69/36). PSD was diagnosed in 43 (41%) patients, 40 (93%) of whom had dysthymia; 22% of patients were already depressed at 1 month. The most frequent depressive symptoms (DSs) were working inhibition, indecisiveness, and fatigability. Patients who developed PSD were less educated (P = 0.044) and diabetic (P = 0.006). After excluding patients that were already depressed at 1 month, we performed a logistic regression model to detect predictors of PSD. Crying (P = 0.012, OR 1.067, CI 0.269-4.553) and guilt (P = 0.007, OR 0.037, CI 0.02i` 03-0.401) at baseline were two DSs found to be significantly correlated with PSD. Higher educational level (P = 0.022, OR 0.084, CI 0.010-0.698) and diabetes (P = 0.007, OR 14.361, CI 2.040-101.108) were the risk factors significantly correlated with PSD. Conclusion: Post-stroke depression is frequent even in patients with minor stroke. Early detection of DSs might help to predict long-term development of PSD. No correlation was observed between lesion site or side and the development of PSD.
引用
收藏
页码:517 / 521
页数:5
相关论文
共 23 条
[1]   CLASSIFICATION OF SUBTYPE OF ACUTE ISCHEMIC STROKE - DEFINITIONS FOR USE IN A MULTICENTER CLINICAL-TRIAL [J].
ADAMS, HP ;
BENDIXEN, BH ;
KAPPELLE, LJ ;
BILLER, J ;
LOVE, BB ;
GORDON, DL ;
MARSH, EE ;
KASE, CS ;
WOLF, PA ;
BABIKIAN, VL ;
LICATAGEHR, EE ;
ALLEN, N ;
BRASS, LM ;
FAYAD, PB ;
PAVALKIS, FJ ;
WEINBERGER, JM ;
TUHRIM, S ;
RUDOLPH, SH ;
HOROWITZ, DR ;
BITTON, A ;
MOHR, JP ;
SACCO, RL ;
CLAVIJO, M ;
ROSENBAUM, DM ;
SPARR, SA ;
KATZ, P ;
KLONOWSKI, E ;
CULEBRAS, A ;
CAREY, G ;
MARTIR, NI ;
FICARRA, C ;
HOGAN, EL ;
CARTER, T ;
GURECKI, P ;
MUNTZ, BK ;
RAMIREZLASSEPAS, M ;
TULLOCH, JW ;
QUINONES, MR ;
MENDEZ, M ;
ZHANG, SM ;
ALA, T ;
JOHNSTON, KC ;
ANDERSON, DC ;
TARREL, RM ;
NANCE, MA ;
BUDLIE, SR ;
DIERICH, M ;
HELGASON, CM ;
HIER, DB ;
SHAPIRO, RA .
STROKE, 1993, 24 (01) :35-41
[2]  
Alexopoulos GS, 1997, ARCH GEN PSYCHIAT, V54, P915
[3]   Delayed poststroke dementia - A 4-year follow-up study [J].
Altieri, M ;
Di Piero, V ;
Pasquini, M ;
Gasparini, M ;
Vanacore, N ;
Vicenzini, E ;
Lenzi, GL .
NEUROLOGY, 2004, 62 (12) :2193-2197
[4]  
[Anonymous], 2001, DIAGN STAT MAN MENT, V4th
[5]   Assessment of Depression After Stroke A Comparison of Different Screening Instruments [J].
Berg, Anu ;
Loennqvist, Jouko ;
Palomaeki, Heikki ;
Kaste, Markku .
STROKE, 2009, 40 (02) :523-529
[6]   The neuropsychiatry of stroke [J].
Chemerinski, E ;
Robinson, RG .
PSYCHOSOMATICS, 2000, 41 (01) :5-14
[7]   The validity of the Beck Depression Inventory-Short Form as a screening and diagnostic instrument for moderate and severe depression in medical inpatients [J].
Furlanetto, LM ;
Mendlowicz, MV ;
Bueno, JR .
JOURNAL OF AFFECTIVE DISORDERS, 2005, 86 (01) :87-91
[8]   Predictors of depression after stroke - A systematic review of observational studies [J].
Hackett, ML ;
Anderson, CS .
STROKE, 2005, 36 (10) :2296-2301
[9]   Global variation in stroke burden and mortality: estimates from monitoring, surveillance, and modelling [J].
Johnston, S. Claiborne ;
Mendis, Shanthi ;
Mathers, Colin D. .
LANCET NEUROLOGY, 2009, 8 (04) :345-354
[10]   NEW DEPRESSION SCALE DESIGNED TO BE SENSITIVE TO CHANGE [J].
MONTGOMERY, SA ;
ASBERG, M .
BRITISH JOURNAL OF PSYCHIATRY, 1979, 134 (APR) :382-389