Effect of Post-stroke Depression on Functional Outcomes of Patients With Stroke in the Rehabilitation Ward: A Retrospective Cohort Study

Yoshitaka Wada; Yohei Otaka; Taiki Yoshida; Kanako Takekoshi; Raku Takenaka; Yuki Senju; Hirofumi Maeda; Seiko Shibata; Taro Kishi; Satoshi Hirano

doi:10.1016/j.arrct.2023.100287

Effect of Post-stroke Depression on Functional Outcomes of Patients With Stroke in the Rehabilitation Ward: A Retrospective Cohort Study

Arch Rehabil Res Clin Transl. 2023 Aug 2;5(4):100287. doi: 10.1016/j.arrct.2023.100287. eCollection 2023 Dec.

Authors

Affiliations

¹ Department of Rehabilitation Medicine Ⅰ, School of Medicine, Fujita Health University, Toyoake, Japan.
² Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan.
³ Department of Nursing, Fujita Health University Hospital, Toyoake, Japan.
⁴ Department of Psychiatry, School of Medicine, Fujita Health University, Toyoake, Japan.

Abstract

Objective: To investigate the prevalence of post-stroke depression in a rehabilitation ward and elucidate its effect on functional improvement and outcomes.

Design: Retrospective cohort study.

Setting: A convalescent rehabilitation ward at a University Hospital.

Participants: A total of 114 patients with stroke (mean [SD] age, 67.2 [13.5] years; men, 76) assessed at 2 weeks after admission using the Mini-International Neuropsychiatric Interview were enrolled.

Main outcome measure: Functional independence measure (FIM) efficiency during hospitalization in the ward.

Results: Eleven patients (9.6%) had depression based on the Mini-International Neuropsychiatric Interview. Total FIM efficiency and FIM efficiency in the subtotal of motor items were significantly higher in the non-depression group than in the depression group (median [interquartile range]: 0.69 [0.39-0.95] vs 0.41 [0.24-0.63], P=.027; and 0.56 [0.38-0.80] vs 0.42 [0.18-0.49], P=.023, respectively). Patients in the non-depression group had higher FIM scores at discharge (median [interquartile range]: 116.0 [104.5-123.0] vs 104.0 [82.5-112.0], P=.013, respectively), and were more likely to be discharged home (80.6% vs 36.4%, P=.003). Furthermore, patients in the depression group also stayed significantly longer in the ward (71.0 [36.1] vs 106.1 [43.3], P=.010).

Conclusions: Patients with post-stroke depression showed poorer efficiency of functional recovery than those without depression. A future multicenter study with a larger sample size is needed to verify these findings.

Keywords: Activities of daily living; Cerebrovascular disorders; Comorbidity; Depression; Rehabilitation.