Author:
DESMOND DAVID W.,REMIEN ROBERT H.,MORONEY JOAN T.,STERN YAAKOV,SANO MARY,WILLIAMS JANET B.W.
Abstract
Previous studies of depression after stroke have reported widely
variable findings, possibly due to differences between studies
in patient characteristics and methods for the assessment of
depression, small sample sizes, and the failure to examine
stroke-free reference groups to determine the base rate of
depression in the general population. In an effort to address
certain of those methodologic issues and further investigate
the frequency and clinical determinants of depression after
stroke, we administered the Structured Interview Guide for the
Hamilton Depression Rating Scale (SIGH–D) and neurological,
neuropsychological, and functional assessments to 421 patients
(age = 71.5 ± 8.0 years) 3 months after ischemic stroke
and 249 stroke-free control subjects (age = 70.8 ± 6.7
years). We required a SIGH–D total score > 11 for the
identification of depression. We found that depression was less
frequent (47/421 patients, or 11.2%, and 13/249 control
subjects, or 5.2%), less severe, and less persistent in our
stroke cohort than previously reported, possibly due to the
underrepresentation of patients with a premorbid history of
affective illness. Depression was associated with more severe
stroke, particularly in vascular territories that supply limbic
structures; dementia; and female sex. SIGH–D item analyses
suggested that a reliance on nonsomatic rather than somatic
symptoms would result in the most accurate diagnoses of depression
after ischemic stroke. (JINS, 2003, 9,
429–439.)
Publisher
Cambridge University Press (CUP)
Subject
Psychiatry and Mental health,Neurology (clinical),Clinical Psychology,General Neuroscience
Cited by
43 articles.
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