title: A prospective study of predictors of poststroke depression.
abstract: OBJECTIVE
  To investigate the association between early depressive behavior after stroke onset and occurrence of poststroke depression (PSD) at 3- and 12-month follow-up evaluations.
  
  
  METHODS
  The study prospectively included 273 patients with first-ever single uncomplicated ischemic stroke. In the stroke unit, nurses scored crying, overt sadness, and apathy daily using an observational method to include patients with comprehension deficits. The Barthel Index was used to assess disability. Follow-up evaluation at months 3 and 12 included psychiatric assessment based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition.
  
  
  RESULTS
  Crying (19.8%), overt sadness (50.5%), and apathy (47.6%) were observed. Of the patients observed crying, 4 showed pathologic crying, 19 emotionalism, and 12 catastrophic reactions. Crying and overt sadness, but not apathy, were associated with a subjective experience of depression (p < 0.05). Thirty of 52 (58%) patients observed crying, 12 of 19 (63%) patients with emotionalism, and 5 of 12 (41%) patients with catastrophic reactions developed PSD within the first year. Multiple logistic regression analysis showed that only severe functional disability (odds ratio [OR], 4.31; 95% CI, 2.41 to 7.69), crying behaviors (OR, 2.66; 95% CI, 1.35 to 5.27), and an age <68 years (OR, 2.32; 95% CI, 1.30 to 4.13) were (p < 0.05) predictors of late PSD development (13% of the variance).
  
  
  CONCLUSIONS
  In the stroke unit, crying and overt sadness are more reliable indicators of depressed mood than apathy. In patients with first-ever stroke, crying behaviors soon after stroke, a younger age, and severe disability are predictors of poststroke depression occurrence within the first year after stroke onset.
authors.affiliation: Department of Neurology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Carota
authors.forename: A
authors.initials: A
authors.lastname: Berney
authors.forename: S
authors.initials: S
authors.lastname: Aybek
authors.forename: G
authors.initials: G
authors.lastname: Iaria
authors.forename: F
authors.initials: F
authors.lastname: Staub
authors.forename: F
authors.initials: F
authors.lastname: Ghika-Schmid
authors.forename: L
authors.initials: L
authors.lastname: Annable
authors.forename: P
authors.initials: P
authors.lastname: Guex
authors.forename: J
authors.initials: J
authors.lastname: Bogousslavsky
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000523:psychology*; D032882:Comprehension; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D004644:Emotions; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D013666:Tears