Evaluation of depression status and its influencing factors in convalescent elderly patients with first-episode stroke

Shiming Li; Bingbing Guo; Queping Yang; Jieyun Yin; Lin Tian; Haohao Zhu; Yingying Ji; Zhenhe Zhou; Ying Jiang

doi:10.1016/j.ajp.2022.103252

Evaluation of depression status and its influencing factors in convalescent elderly patients with first-episode stroke

Asian J Psychiatr. 2022 Nov:77:103252. doi: 10.1016/j.ajp.2022.103252. Epub 2022 Sep 6.

Authors

Shiming Li¹, Bingbing Guo², Queping Yang¹, Jieyun Yin³, Lin Tian¹, Haohao Zhu⁴, Yingying Ji⁵, Zhenhe Zhou⁶, Ying Jiang⁷

Affiliations

¹ The affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China.
² The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi, Jiangsu 214002, China.
³ School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu 215123, China.
⁴ The affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China. Electronic address: zhuhaohao233@163.com.
⁵ The affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China. Electronic address: miaomiao19870@163.com.
⁶ The affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China. Electronic address: zhouzh@njmu.edu.cn.
⁷ The affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China. Electronic address: jiangying911010@163.com.

PMID: 36095881
DOI: 10.1016/j.ajp.2022.103252

Abstract

Objective: To investigate the occurrence and the influencing factors of post-stroke depression (PSD) in first-episode stroke.

Methods: A total of 350 elderly stroke patients who were admitted to Wuxi Central Rehabilitation Hospital for the first time from January 2020 to December 2020 were enrolled in this study. The Hamilton Depression Scale (HAMD) was used to evaluate the depression status of stroke patients. The sociodemographic data, clinical symptoms, social environment and behavioral patterns of the patients were collected to analyze the related factors of depression after stroke through SPSS 20.0 software.

Results: The incidence of PSD was 45.71%. There were statistical differences among different gender, lesion nature, lesion location, smoking, hypertension, diabetes, hospitalization enpenses, season of onset, BMI index, NIHSS score, barthel index score, blood pressure variation coefficient and other factors (p = 0.000). Post-stroke depression score was positively correlated with NIHSS score and coefficient of variation of systolic blood pressure (r = 0.935, p = 0.000; r = 0.921, p = 0.000), and negatively correlated with barthel index score (r = -0.964, p = 0.000). Through multivariate Logistic regression analysis, it was found that male (OR=8.624, 95%CI: 5.672-11.715), cerebral infarction (OR=2.561, 95%CI: 1.256-3.567), and the right side lesion (OR=1.933, 95%CI: 1.024-3.026), smoking (OR=2.457, 95%CI: 1.611-3.625), onset in autumn and winter (OR=2.049, 95%CI: 1.201-2.919), high BMI (OR=2.461, 95%CI): 1.426-3.432) were risk factors for depression after stroke, and low SBPV (OR=0.567, 95%CI: 0.352-0.758) and low NISHH score (OR=0.256, 95%CI: 0.105-0.486) were the protective factor for subsequent depression of stroke.

Conclusion: Males, smoking, patients with onset in autumn and winter, lesions on the right side, high BMI, high NISHH score and high systolic blood pressure variation were closely related to PSD, which should be paid for attention for such patients to prevent the occurrence of PSD and take intervention measures.

Keywords: Depression; Influencing factors; Logistic analysis; Stroke.

MeSH terms

Aged
Humans
Incidence
Male
Risk Factors
Stroke* / complications
Stroke* / epidemiology