Depression in a situation of persistent motor handicap: Case of vascular hemiplegia in an African context

Abstract

Post-stroke depression is a very common nosological entity and its perception in Africa is sometimes experienced as a stigmatizing situation, often poorly accepted. To specify the incidence of depression after vascular hemiplegia, and also its functional repercussion in rehabilitation in the PMR department at Yopougon's University Hospital. It was an eight-month prospective cross-sectional study from January to August 2016. It involved all cases of patients with hemiplegia following a stroke managed in the PMR service. Patients presenting in addition severe cognitive impairment were excluded. On 49 hemiplegic patients, 19 patients with a mean age of 57.21 years with extremes of 37 and 70 years had post-stroke depression (38.8%), mostly men with a sex ratio of 1, 71. Ischemic stroke represented 89.5% of the PSD; 11 patients (57.9%) had minor depression and 8 patients (42.1%) had severe depression. There was a suicidal risk in 6 patients, 31.6%. Motor handicap was present in all depressed patients with an average Demeurisse's score at 55.16/100 and extremes ranging from 9 up to 80. Post-stroke depression is common in our context despite its debilitating and poorly accepted nature by a segment of the general population. It compromises the functional prognosis, which is a source of demotivation for patients, especially for the execution of the rehabilitation program. Post-stroke depression should be searched systematically in all hemiplegic vascular in our African context, during the decline in performance and achievements during rehabilitation sessions, and during regular meetings with the family.