Functional impairment and post-stroke depression: a 6-month longitudinal study
Larissa P. Borlina Beltrami, Paula Teixeira Marques, Francisco Jaime Lopes Barbosa, Viviane H. Flumignan Zetola, Marcos Christiano Lange, Raffael Massuda
Abstract
Objective
In recent decades, there have been considerable advances in treatment and prevention of acute ischemic stroke (IS). However, even after treatment, approximately two-thirds of patients with IS have some degree of disability that requires rehabilitation, along with an increased likelihood of developing psychiatric disorders, particularly depression. The objective of this study was to determine the predictors of post-stroke depression in a 6-month period in patients with IS.
Methods
Ninety-seven patients with IS without previous depression were included in the study. The study protocol was applied during hospitalization and at 30, 90, and 180 days after hospital discharge. A binary logistic regression was then conducted. Age, sex, marital status, occupation, educational level, thrombolysis, National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS) score, Barthel Index (BI), and Mini-Mental State Examination (MMSE) score were included as independent variables.
Results
Of the 97 patients, 24% of patients developed post-stroke depression. In the longitudinal follow-up, an mRS score of > 0 was the lone significant predictor of development of depression (odds ratio [OR] = 5.38; 95% confidence interval [95%CI] 1.25-23.12; p < 0.05).
Conclusion
Our results showed that in patients without previous depression, functional impairment of any degree is associated with a 5-fold greater chance of development of depression in the first 6 months post-stroke compared to patients without functional impairment.
Submitted date:
11/15/2022
Accepted date:
03/23/2023