Poststroke depression -: An 18-month follow-up
Poststroke depression -: An 18-month follow-up
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DOI：
10.1161/01.str.0000048149.84268.07
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发表时间：
2003-01-01
期刊：
影响因子：
8.3
通讯作者：
Kaste, M
中科院分区：
文献类型：
--
作者：
Berg, A;Psych, L;Kaste, M
背景和目的：本前瞻性研究旨在研究中风后18个月内抑郁症状的病程、相关因素和预测因素。方法对100例脑卒中患者进行为期18个月的随访。在中风后2周、2、6、12和18个月用贝克抑郁量表和汉密尔顿抑郁评定量表评估抑郁症状，并根据《精神障碍诊断与统计手册》第三版修订中列出的标准进行诊断。卒中严重程度用斯堪的纳维亚卒中量表评估，认知功能用综合神经心理学测试评估。患者参加了抗抑郁药物的随机临床试验。结果：总体而言，54%的患者在随访期间的某个时间至少感到轻度抑郁；46%在前2个月抑郁的患者在12个月和/或18个月时也抑郁。只有12%的患者在12或18个月时首次出现抑郁。在随访期间，男性与抑郁症状的负面变化相关。年龄较大与前2个月的抑郁症状、6 - 12个月的中风严重程度以及18个月的男性有关。抑郁症状与病变部位无关。结论：抑郁症状是常见的，而且往往有慢性病程。抑郁症与中风的严重程度和功能损害有关，而且与18个月大的男性有关。应关注情绪障碍的长期预后和适应。
Background and Purpose-This prospective study was designed to examine the course, associates, and predictors of depressive symptoms during the first 18 months after stroke.Methods-A total of 100 patients were followed up for 18 months after stroke. Depressive symptoms were assessed at 2 weeks and 2, 6, 12, and 18 months after stroke with the Beck Depression Inventory and the Hamilton Rating Scale for Depression, and diagnoses were performed using criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised. Stroke severity was assessed with the Scandinavian Stroke Scale and cognitive functions with a comprehensive neuropsychological battery. Patients participated in a randomized clinical trial of antidepressive medication.Results-In all, 54% of patients felt at least mildly depressive at some time during the follow-up; 46% of those who were depressive during the first 2 months were also depressive at 12 and/or 18 months. Only 12% of patients were depressive for the first time at 12 or 18 months. The male sex was associated with a more negative change in depressive symptoms during the follow-up. Older age was associated with depressive symptoms during the first 2 months, stroke severity from 6 to 12 months, and the male sex at 18 months. Depressive symptoms were unrelated to the lesion location.Conclusions-Depressive symptoms are frequent and they often have a chronic course. Depression is associated with stroke severity and functional impairment, and with the male sex at 18 months. Attention should be focused on the long-term prognosis of mood disturbances and adaptation.