Post-stroke depression: can we predict its development from the acute stroke phase?
OBJECTIVE
To identify possible predictive factors for post-stroke depression (PSD) in the acute phase of stroke.


METHODS
The study design was prospective, observational cohort study of patients with acute cerebral infarction (CI). Neurological and neuropsychological evaluations were conducted within the first 10 days from the onset of stroke and repeated at the 3-month follow-up. DSM-IV criteria were used to define PSD.


RESULTS
From a total of 85 patients with CI, 59 patients completed the 3-month follow-up and 17 of them (28.8 %) fulfilled PSD criteria at the 3-month follow-up. Melancholy index of the Hamilton Depression Rankin Scale (HDRS) was associated with a risk three times greater than that of PSD at the 3-month follow-up in the univariate analysis (OR 3.07; 95% CI 1.53-6.16; P = 0.002) with no significant influence of stroke severity or the location of brain infarction (right or left side). The receiver operating characteristic curves pointed to a melancholy index > or =1.5 as the optimal cut-off level associated with the development of PSD at the 3-month follow-up.


CONCLUSIONS
Melancholy index of the HDRS > or =1.5 could be a useful clinical tool to detect patients with acute stroke at high risk of developing PSD.
Fuentes
B
B
Department of Neurology, University Hospital La Paz, UAM, Madrid, Spain.
Ortiz
X
X
Sanjose
B
B
Frank
A
A
Díez-Tejedor
E
E
D000368:Aged; D002544:Cerebral Infarction / Q000150:complications* / Q000523:psychology*; D003863:Depression / Q000209:etiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D011446:Prospective Studies