Longitudinal prevalence and determinants of early mood disorder post-stroke.
BACKGROUND
Early identification of mood disorder post-stroke (MDPS) or its determinants could improve stroke outcomes. However, the natural history, prevalence and determinants of MDPS within the first weeks post-stroke require further investigation.


METHODS
Consecutive hospitalised stroke survivors were assessed within 2-5 days of stroke, and at 1 and 3 months post-stroke. Baseline data included demographics, co-morbidities, stroke subtype, pre-stroke disability and cognition. At baseline, 1- and 3-month interviews physical impairment, disability, cognition and social support were assessed. MDPS was defined as a score of >8 on the depression subscale of the Hospital Anxiety Depression Scale. Factors independently associated with MDPS at each time-point were determined using regression analyses.


RESULTS
One hundred and twenty-five subjects were included. The prevalence of MDPS within 5 days and at 1 and 3 months post-stroke was 5%, 16% and 21% respectively. The independent determinants for MDPS at 1 month were disability, social support and change in impairment score between initial and 1-month assessments; and at 3 months were disability, social support and institutionalisation. Individuals moved in and out of the subset of depressed patients over time. MDPS was independently associated with mortality at 3 months post-stroke.


CONCLUSIONS
Mood disorder post-stroke increases in prevalence over the initial weeks post-stroke despite an improvement in disability, and is associated with mortality. Patients with MDPS at 1 month were not necessarily affected at 3 months and vice versa, indicating the dynamic nature of MDPS in the early stages.
Townend
B S
BS
Neurology Department, Gosford Hospital, P.O. Box 361, Gosford 2250, NSW, Australia. towser7@hotmail.com
Whyte
S
S
Desborough
T
T
Crimmins
D
D
Markus
R
R
Levi
C
C
Sturm
J W
JW
D000368:Aged; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000401:mortality; D013997:Time Factors