Depression after minor stroke: the association with disability and quality of life--a 1-year follow-up study

Yu Zhi Shi; Yu Tao Xiang; Yang Yang; Ning Zhang; Shuo Wang; Gabor S Ungvari; Helen F K Chiu; Wai Kwong Tang; Yi Long Wang; Xing Quan Zhao; Yong Jun Wang; Chun Xue Wang

doi:10.1002/gps.4353

Depression after minor stroke: the association with disability and quality of life--a 1-year follow-up study

Int J Geriatr Psychiatry. 2016 Apr;31(4):421-7. doi: 10.1002/gps.4353. Epub 2015 Sep 7.

Authors

Yu Zhi Shi^{1

2}, Yu Tao Xiang³, Yang Yang^{1

2}, Ning Zhang^{1

2}, Shuo Wang^{1

2}, Gabor S Ungvari^{4

5}, Helen F K Chiu⁶, Wai Kwong Tang⁶, Yi Long Wang^{1

2}, Xing Quan Zhao^{1

2}, Yong Jun Wang^{1

2}, Chun Xue Wang^{1

2

7}

Affiliations

¹ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
² China National Clinical Research Center for Neurological Diseases, Beijing, China.
³ Faculty of Health Sciences, University of Macau, Macao SAR, China.
⁴ University of Notre Dame Australia/Marian Centre, Perth, Australia.
⁵ School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia.
⁶ Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.
⁷ Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

PMID: 26343540
DOI: 10.1002/gps.4353

Abstract

Objective: Minor stroke is characterized by mild neurological functional impairment and relatively good outcome. Little is known about the association between post-stroke depression (PSD) and outcomes of minor stroke. The aim of this study was to investigate the association between PSD and disability and quality of life (QoL) at 1 year after minor ischemic stroke.

Methods: Patients with first-ever minor ischemic stroke (n = 747) were followed up at 14 ± 2 days, 3 months, 6 months, and 1 year after stroke. Depressive symptoms were assessed at each follow-up. Patients diagnosed with depression at 14 ± 2 days formed the early-onset PSD group; those who were diagnosed with depression at any subsequent follow-ups for the first time constituted the late-onset PSD group. The outcomes of minor stroke including disability (modified Rankin score ≥ 2) and QoL (Short Form-36 Health Survey) were assessed at the 1-year follow-up.

Results: A total of 198 (26.5%) patients were diagnosed with PSD over the 1-year follow-up; 136 and 62 patients were allocated to the early-onset PSD group and late-onset PSD group, respectively. Both early-onset and late-onset PSD were independently associated with disability and poor physical and mental health at 1 year after stroke. Recovery from depression (n = 112) within 1 year decreased the adverse impacts of PSD on functional outcome and QoL.

Conclusions: Post-stroke depression was independently associated with disability and poor QoL at 1 year after first-ever minor ischemic stroke. Recovery from PSD decreased but did not eliminate the adverse impacts of PSD on outcomes of minor stroke.

Keywords: disability; ischemic stroke; minor stroke; post-stroke depression; quality of life.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Depressive Disorder / etiology*
Disabled Persons / psychology*
Disabled Persons / statistics & numerical data
Female
Follow-Up Studies
Humans
Logistic Models
Male
Middle Aged
Prospective Studies
Quality of Life*
Stroke / psychology*
Time Factors