Abstract
Post-stroke depression (PSD) affects approximately one-third of stroke patients. PSD not only impairs recovery and lowers quality of life, but has also serious neurological consequences, high mortality, and stroke recurrence risks. Studies on PSD-related prognostic factors are still lacking, especially environmental factors. Moreover, relieving factors after PSD in stroke patients has not been reported. This study aimed to investigate (study design 1) risk factors for PSD diagnosis after three months, and (study design 2) related factors for the relieving of early PSD after three months. This retrospective study included 227 patients hospitalized for acute ischemic stroke within three days at Jeonbuk National University Hospital from January to December 2019. The depressive status was assessed using the Hamilton Depression Rating Scale (HDRS) at admission and after three months. Clinical and laboratory data were analyzed for relevant prognostic factors. (Study design 1) HDRS score at admission (adjusted odds ratio (aOR) 1.22, 95% confidence interval (CI) 1.14–1.31; p < 0.001) and hospitalization period (aOR 1.11, 95% CI 1.02–1.20; p = 0.013) were confirmed as prognostic factors of PSD after three months. (Study design 2) The National Institute of Health Stroke Scale (NIHSS) score at discharge (aOR 0.80, 95% CI 0.68–0.94; p = 0.006) and HDRS score at admission (aOR 0.80, 95% CI 0.71–0.89; p < 0.001) were confirmed as prognostic factors of depression improvement after three months. In conclusion, environmental factors such as hospitalization period could be important in managing PSD. Factors related to PSD improvement are expected to be helpful in establishing a strategy for PSD recovery.
Highlights
IntroductionStroke is a major cause of chronic adult disability and has a long recovery process
Post-stroke depression (PSD) is a mood disorder causing depression and anhedonia that occurs in 18–30% of all stroke survivors; only approximately 5% of them are diagnosed with PSD and are treated appropriately [4]
The results showed that the National Institute of Health Stroke Scale (NIHSS) score at discharge and Hamilton Depression Rating Scale (HDRS) score at admission
Summary
Stroke is a major cause of chronic adult disability and has a long recovery process. It is the second leading cause of death worldwide [1]. PSD is a mood disorder causing depression and anhedonia that occurs in 18–30% of all stroke survivors; only approximately 5% of them are diagnosed with PSD and are treated appropriately [4]. Patients diagnosed with PSD tend to feel less happy, feel less interest and pleasure, experience decreased vitality and fatigue, and suffer from suicidal thoughts. They often experience weight loss, insomnia, poor appetite, anxiety, iations
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