Factors associated with post-stroke depression and fatigue: lesion location and coping styles.

Changjuan Wei,Junwei Hao,Nan Zhang,Fang Zhang,Xiaofeng Ma,Li Chen

doi:10.1007/s00415-015-7958-2

Changjuan Wei, Junwei Hao + Show 4 more

Open Access

https://doi.org/10.1007/s00415-015-7958-2

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Abstract

Post-stroke depression (PSD) and post-stroke fatigue (PSF) are frequent and persistent problems among stroke survivors. Therefore, awareness of signs and symptoms of PSD and PSF is important for their treatment and recovery from stroke. Additionally, since sudden serious illness can result in disequilibrium, early institution of a coping process is essential to restoring stability. The brain damage of stroke leaves patients with unique physical and mental dysfunctions for which coping maybe a key resource while rebuilding lives. We evaluated 368 consecutive patients with acute ischemic stroke for post-stroke emotional disorders at admission and 3 months later. PSD was evaluated by using the Beck Depression Inventory, and PSF was scored with the Fatigue Severity Scale. The Social Support Rating Scale and Medical Coping Modes Questionnaire were also used as measurement tools. Locations of lesions were based on MRI. Those scans revealed infarcts located in the basal ganglia, corona radiate and internal capsule and constituted the independent factors associated with PSF 3 months after stroke occurrence. Conversely, PSD was not related to lesion location. Acceptance-resignation related to PSD and PSF both at admission and 3 months after stroke. Avoidance was the independent factor most closely related to PSD, whereas confrontation was the independent factor best related to PSF at 3 months after stroke onset.

Highlights

Each year, of the approximately 15 million human stroke victims worldwide, at least five million die, and one-third remain disabled [1]
Those scans revealed infarcts located in the basal ganglia, corona radiate and internal capsule and constituted the independent factors associated with post-stroke fatigue (PSF) 3 months after stroke occurrence
With respect to localization of brain damage, basal ganglia, corona radiate or internal capsule infarctions were the independent factors associated with PSF 3 months after stroke occurrence, whereas cerebellum infarction was not susceptible to PSF

Summary

Introduction

Of the approximately 15 million human stroke victims worldwide, at least five million die, and one-third remain disabled [1]. Post-stroke depression (PSD) mainly manifested as sadness, reduction of interest and pleasure, and multiple psychological and vegetative symptoms [4] afflicts 20–65 % of these patients, depending on the population studied, the assessment measures, and the definition of depression applied [5]. In a Swedish study, 49 % of patients with fatigue 1 year after stroke were diagnosed with depression compared with 39 % in the total sample [8]. In a Korean study, 34 % of patients diagnosed as depressed were among those with fatigue approximately 15 months after stroke [7]. PSF accompanying PSD is often relieved when the depression is adequately treated [11].

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