[Two simple questions to diagnose post-stroke depression].
OBJECTIVE
Many patients develop a depression after having suffered a stroke. Such a Post-Stroke Depression (PSD) impairs rehabilitation and quality of life. PSD is underdiagnosed in spite of available treatment. Several questionnaires have been created to diagnose a PSD. But questionnaires have been considered cumbersome and time-consuming. The aim of this study was to find out whether two simple, standardised questions will identify those stroke patients, who have developed a PSD.


METHODS
The two case-finding questions and the Beck Depression Inventory (BDI) were sent to patients of the Berlin Acute Stroke Study (BASS) four years after their stroke. Incomplete questionnaires were complemented via mail or telephone. Severity of depression was assessed by means of BDI.


RESULTS
Out of 211 patients, 199 responded to the questionnaire (94 %). 193 questionnaires were complete (97 %). Forty-two patients affirmed both case-finding questions (22 %). Compared to patients, who did not affirm both questions, these patients had a higher BDI score (19 +/- 8 vs. 7 +/- 5; p < 0.001). The sensitivity and specificity of the two questions were 89 % and 90 %, respectively. The positive and negative predictive value were 60 % and 98 % respectively. The number of confirmed questions (0, 1, 2) correlated well with the BDI score (r (2) = 0.67, p < 0.001).


CONCLUSIONS
Two standardized questions can identify patients with PSD for further diagnostic evaluation and therapy. Diagnosis of PSD might be facilitated by using them as screening instrument.
Klinik und Poliklinik für Neurologie der Charite-Universitätsmedizin in Berlin. christian.nolte@charite.de
C H
CH
Nolte
J
J
Müller-Nordhorn
G J
GJ
Jungehülsing
K
K
Rossnagel
A
A
Reich
S
S
Roll
I
I
Laumeier
D
D
Beerfelde
S N
SN
Willich
A
A
Villringer
D000368:Aged; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D020521:Stroke / Q000150:complications* / Q000523:psychology; D011795:Surveys and Questionnaires