Depression or apathy and functional recovery after stroke.
OBJECTIVE
While depression and apathy are common after stroke, past studies have done little to examine the influence of these two symptoms on functional outcome respectively. This study was designed to examine the effect of depression or apathy on functional recovery after stroke in 237 Japanese stroke patients.


METHODS
We assessed the psychological status using self-rating scales [the Zung Self-Rating Depression Scale (SDS) for depression and the Apathy Scale (AS) for apathy] and an observer-rating scale [the Neuropsychiatric Inventory (NPI)]. We assessed physical disability using the Functional Independence Measurement (FIM). Post-hoc test and multiple regression analysis were used to determine the independent effects of post-stroke depression and apathy on functional outcome.


RESULTS
Depression was observed in 75 (31.6%) using SDS and 88 (40.2%) using NPI, and apathy in 95 (40.1%) using AS and 42 (19.2%) using NPI, respectively. Post-hoc test and multiple regression analysis indicated that the cognitive variable (Mini-Mental State Examination: MMSE score) and AS score, but not SDS score, correlated negatively with improvement in FIM.


CONCLUSIONS
Apathy might be more frequently associated with functional abilities and likely interact with the recovery process as compared with depression after stroke.
Hama
Seiji
S
Department of Rehabilitation, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan. wel@welnet.jp
Yamashita
Hidehisa
H
Shigenobu
Masaya
M
Watanabe
Atsuko
A
Hiramoto
Keiko
K
Kurisu
Kaoru
K
Yamawaki
Shigeto
S
Kitaoka
Tamotsu
T
D000342:Affective Symptoms / Q000209:etiology*; D000368:Aged; D003866:Depressive Disorder / Q000209:etiology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D020127:Recovery of Function / Q000502:physiology*; D012044:Regression Analysis; D020521:Stroke / Q000150:complications / Q000523:psychology*