Abstract WP145: Depression in Stroke and TIA Survivors With Minimal or No Residual Deficits

Abstract

Background: Depression after stroke can severely inhibit a patient’s recovery. While it affects roughly a third of all stroke survivors, there is a lack of literature evaluating depression in patients with minimal or no residual deficits. Objectives: To evaluate variables associated with depression in patients with minimal or no residual deficits. Methods: A retrospective analysis of patients with mild stroke, intracerebral hemorrhage (ICH) or TIA at our institution who presented to the stroke clinic from December 2016-July 2017 was conducted. A questionnaire gathering clinical and sociodemographic information, as well as levels of depression, was administered. Patients were assessed using the PHQ-2 and PHQ-9 depression scales. A Wilcoxon Ranked Sum test was used to analyze variables affecting depression. Statistical significance was set at 0.05. Results: In total, 72 patients (58 ischemic, 5 ICH and 9 TIA) were identified. Approximately 4% (n=3) presented to clinic <6 weeks, 66.7% (n=48) 6-12 weeks, 23.6% (n=17) 12-24 weeks, and 5.6% (n=4) > 24 weeks from discharge. The median discharge NIH score was 1.5. Roughly 24% of patients (n=17) reported depression via the PHQ-9. Of these patients, 59% (n=10) reported depression prior to stroke and 41% (n=7) developed new depression. The median age was 62.5 years, 63.9% were female, and 70.8% Caucasian. Diabetic and unmarried patients reported significantly more depression ( p=0.005, 0.03) while patients attending occupational therapy were less depressed ( p=0.010 ). Age ( p=0.23 ), history of cancer ( p=0.95 ), prior stroke ( p=0.55 ), incontinence ( p=0. 27), stroke location (Right: p=0.72 ; Left: p=0.244 ), ability to return to work ( p=0.64 ), driving status ( p= 0.36), and discharge destination ( p=0. 09) did not significantly affect depression levels. Of the patients with no prior depression, 11.2% developed new depression after stroke. Conclusion: In our study, a quarter of stroke and TIA patients with little to no residual deficits reported depression and roughly 1 in 10 reported new depressive symptoms. Depression is still a prevalent and concerning outcome that can have a major effect on a patient’s functional status. Further studies of depression in patients with minimal to no symptoms are needed.