Long-term incidence of depression and predictors of depressive symptoms in older stroke survivors
Long-term incidence of depression and predictors of depressive symptoms in older stroke survivors
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DOI：
10.1192/bjp.bp.113.128355
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发表时间：
2013-12-01
影响因子：
10.5
通讯作者：
Kalaria, Raj N.
中科院分区：
文献类型：
--
作者：
Allan, Louise M.;Rowan, Elise N.;Kalaria, Raj N.
背景抑郁症很常见，是中风的一个重要后果，但有关这些疾病之间长期关系的信息有限。目的确定中风后 3 个月至 10 年的 75 岁以上中风幸存者的二级护理队列中抑郁症的患病率、发病率和预测因素。方法每年通过三种方法评估抑郁症：根据 DSM-IV 标准的重度抑郁症、自评老年抑郁症 抑郁量表 (GDS) 和观察者评定的康奈尔量表。结果我们发现，使用 GDS 时抑郁症状的基线患病率最高，为 31.7%，而使用康奈尔量表时为 9.7%，使用 DSM-IV 标准时为 1.2%。发病率分别为每100人年36.9次、5.90次和4.18次。在单变量和多变量分析中，基线 GDS 评分是所有时间点抑郁症状最一致的预测因子。其他预测因素包括认知障碍、日常生活和早期活动受损、血管危险因素负担和痴呆。结论我们的结果强调了对早发性中风后抑郁症患者进行精神随访的重要性，以及对中风后仍处于抑郁高风险人群中长期监测情绪的重要性。
BackgroundDepression is common and an important consequence of stroke but there is limited information on the longer-term relationship between these conditions.AimsTo identify the prevalence, incidence and predictors of depression in a secondary-care-based cohort of stroke survivors aged over 75 years, from 3 months to up to 10 years post-stroke.MethodDepression was assessed annually by three methods: major depression by DSM-IV criteria, the self-rated Geriatric Depression Scale (GDS) and the observer-rated Cornell scale.ResultsWe found the highest rates, 31.7% baseline prevalence, of depressive symptoms with the GDS compared with 9.7% using the Cornell scale and 1.2% using DSM-IV criteria. Incidence rates were 36.9, 5.90 and 4.18 episodes per 100 person years respectively. Baseline GDS score was the most consistent predictor of depressive symptoms at all time points in both univariate and multivariate analyses. Other predictors included cognitive impairment, impaired activities of daily living and in the early period, vascular risk factor burden and dementia.ConclusionsOur results emphasise the importance of psychiatric follow-up for those with early-onset post-stroke depression and long-term monitoring of mood in people who have had a stroke and remain at high risk of depression.