Improved recovery in activities of daily living associated with remission of poststroke depression.
OBJECTIVE
Poststroke depression is associated with impaired recovery of activities of daily living (ADL) function compared with similar nondepressed patients. We examined the differences on recovery of ADL functions among poststroke depressed patients with remission of their depression compared with poststroke depressed patients without mood recovery over the first 3 to 6 months after stroke.


METHODS
On the basis of a semistructured psychiatric examination and DSM-IV diagnostic criteria, a consecutive series of patients with poststroke major or minor depression (n=55) were selected. Their impairment in ADL function was assessed by means of the Johns Hopkins Functioning Examination during acute hospitalization and either 3 or 6 months later.


RESULTS
Patients whose mood improved at follow-up (n=21) had significantly greater recovery in ADL functions at follow-up than patients whose mood did not improve (n=34). There were no differences in demographic variables, lesion characteristics, and neurological symptoms between the two groups. Furthermore, patients with either major or minor depression at the initial evaluation showed the same amount of recovery in ADL function if they improved at follow-up.


CONCLUSIONS
Our findings suggest that remission of poststroke depression over the first few months after stroke is associated with greater recovery in ADL function than continued depression. Early effective treatment of depression may have a positive effect on the rehabilitation outcome of stroke patients.
Chemerinski
E
E
Department of Psychiatry, The University of Iowa College of Medicine, Iowa City 52242, USA. eran-chemerinski@uiowa.edu
Robinson
R G
RG
Kosier
J T
JT
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015142:Baltimore; D003710:Demography; D003866:Depressive Disorder / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007484:Iowa; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011379:Prognosis; D020127:Recovery of Function; D012075:Remission, Spontaneous; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000523:psychology; D000071939:Stroke Rehabilitation