Depressive disorders in long-term survivors of stroke. Associations with demographic and social factors, functional status, and brain lesion volume.
Sixty surviving patients from a community-based stroke register who had computerised tomography (CT) scan evidence of a single brain lesion were interviewed three to five years after their first ever stroke. Depression (DSM-III-R major depression, partially resolved major depression, and dysthymia) was present in 11 (18%) of the patients and was associated with impaired physical and cognitive functioning, greater age, residence in an institution, absence of a close personal relationship, and larger original brain lesion. Of these variables, only functional dependence (odds ratio 16.4; confidence interval 1.6-170), larger lesion volume (6.6; 1-50), and female sex (8; 1.1-56) remained significantly associated with depression after controlling for all other variables. We conclude that depression in long-term survivors of stroke has many of the same associations as depression in non-stroke elderly populations. Depression in long-term stroke survivors may also be associated with larger original brain lesions, although this requires confirmation in a prospective study.
Sharpe
M
M
University Department of Psychiatry, Warneford Hospital, Oxford.
Hawton
K
K
Seagroatt
V
V
Bamford
J
J
House
A
A
Molyneux
A
A
Sandercock
P
P
Warlow
C
C
D000367:Age Factors; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D016001:Confidence Intervals; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012737:Sex Factors; D012917:Social Adjustment; D014057:Tomography, X-Ray Computed