The Natural History of Depression up to 15 Years After Stroke The South London Stroke Register
The Natural History of Depression up to 15 Years After Stroke The South London Stroke Register
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DOI：
10.1161/strokeaha.111.679340
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发表时间：
2013-04-01
期刊：
影响因子：
8.3
通讯作者：
Rudd, Anthony G.
中科院分区：
文献类型：
--
作者：
Ayerbe, Luis;Ayis, Salma;Rudd, Anthony G.
背景与目的：关于脑卒中后抑郁的自然病史的证据仍不足以为预后和治疗策略提供信息。本研究估计中风后15年内抑郁症的发病率、累积发病率、患病率、发病时间、持续时间和复发率。方法：数据来自1995年至2009年在南伦敦卒中登记处登记的患者（N=4022）。这些分析的最大参与者数n=1233)。在卒中后3个月，卒中后1年，以及此后每年直至卒中后15年，使用医院焦虑和抑郁量表（评分bbb70 =抑郁）对所有患者进行抑郁评估。采用逆概率加权法计算缺失数据的估计。结果：脑卒中后15年内抑郁症的发生率为7% ~ 21%，累计发病率为55%，患病率为29% ~ 39%。大多数抑郁症发作是在中风后的一年内开始的，33%的病例是在中风后的3个月内开始的，而在第10年以后就没有了。50%的抑郁患者在3个月后中风一年后恢复。卒中后抑郁复发的比例从第2年的38%逐渐增加到第14年和第15年的100%。结论：脑卒中后抑郁的自然历史是动态的。抑郁症影响大多数中风患者，发作时间短，但长期复发的风险高。(中风。2013;44:1105 - 1110)。
Background and Purpose-Evidence on the natural history of depression after stroke is still insufficient to inform prognosis and treatment strategies. This study estimates the incidence, cumulative incidence, prevalence, time of onset, duration, and recurrence rate of depression up to 15 years after stroke.Methods-Data from patients registered in the South London Stroke Register between 1995 and 2009 were used (N=4022 at registration. Maximum number of participants for these analyses n=1233). Depression was assessed in all patients with the Hospital Anxiety and Depression Scale (scores >7=depression) 3 months after stroke, 1 year after stroke, and annually thereafter up to 15 years after stroke. Inverse probability weighting was used to calculate the estimates accounting for missing data.Results-The poststroke incidence of depression ranged from 7% to 21% in the 15 years after a stroke, with cumulative incidence of 55% and prevalence ranging from 29% to 39%. Most episodes of depression started within a year of stroke, with 33% of the cases starting in the 3 months after a stroke, and none from year 10 onward. Fifty percent of the patients with depression at 3 months had recovered 1 year after stroke. The proportion of recurrent episodes of depression after stroke increased gradually from 38% in year 2 to 100% in years 14 and 15.Conclusions-The natural history of depression after stroke is dynamic. Depression affects most of the stroke patients with episodes that have a short duration but a high risk of recurrence in the long term. (Stroke. 2013;44:1105-1110.)