Poststroke depression: prevalence and determinants in Brazilian stroke patients.
BACKGROUND
Poststroke depression (PSD) is one of the most important long-term adverse psychosocial consequences in stroke survivors. Our objective was to assess the prevalence of PSD in Brazilian stroke patients and identify significant associated factors.


METHODS
A cross-sectional study of stroke patients consecutively admitted for rehabilitation was conducted. The patients were evaluated by means of the NIH Stroke Scale, Mini-Mental State Examination, Barthel Index, Lawton Scale, modified Rankin Scale, Hospital Anxiety and Depression Scale (HADS), Geriatric Depression Scale (GDS) and MOS-Short Form 36. Patients with a HADS-depression subscale score > or = 11 and/or GDS score > or = 8 were classified as depressed.


RESULTS
Three hundred stroke survivors were assessed (mean age: 56.3 years; 51.7% males). Half (46.7%) of the stroke patients had an m-RS score < or = 2. The proportion of stroke patients who scored > or = 11 points on the HADS-depression and HADS-anxiety subscales were 19.2 and 23.7%, respectively. One third (29.7%) had a GDS mean score > or = 8. The GDS scores significantly correlated (p < 0.0001) with the HADS-depression (r = 0.51) and HADS-anxiety subscales (r = 0.54). The prevalence of mood disorders was significantly higher in females than in males (24.8 vs. 14.2%; x(2), p = 0.03). PSD was significantly associated (p < 0.0001) with work status (housewife), education level, lower social and cognitive functioning, dependence in the instrumental activities of daily living and presence of diabetes in the multivariable regression analysis (R adjusted = 0.32).


CONCLUSIONS
PSD was highly prevalent in the chronic phase of stroke. Early detection and recognition of associated risk factors is important to treat and prevent PSD in a rehabilitation setting.
Carod-Artal
Francisco Javier
FJ
Department of Neurology, Sarah Network of Rehabilitation Hospitals, Sarah Hospital, Brasilia, Brazil. fjcarod-artal@hotmail.com
Ferreira Coral
Luciane
L
Trizotto
Daniele Stieven
DS
Menezes Moreira
Clarissa
C
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D044467:American Indian or Alaska Native / Q000706:statistics & numerical data*; D001007:Anxiety / Q000208:ethnology / Q000209:etiology; D001938:Brazil / Q000453:epidemiology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000208:ethnology / Q000209:etiology* / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000523:psychology; D004185:Disability Evaluation; D004522:Educational Status; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology*; D000071939:Stroke Rehabilitation