Importance of retardation and fatigue/interest domains for the diagnosis of major depressive episode after stroke: a four months prospective study.
OBJECTIVE
Post-stroke major depressive episode is very frequent, but underdiagnosed. Researchers have investigated major depressive episode symptomatology, which may increase its detection. This study was developed to identify the depressive symptoms that better differentiate post-stroke patients with major depressive episode from those without major depressive episode.


METHODS
We screened 260 consecutive ischemic stroke patients admitted to the neurology clinic of a university hospital. Seventy-three patients were eligible and prospectively evaluated. We assessed the diagnosis of major depressive episode using the Structured Clinical Interview for DSM-IV and the profile of depressive symptoms using the 31-item version of the Hamilton Depression Rating Scale. For data analysis we used cluster analyses and logistic regression equations.


RESULTS
Twenty-one (28.8%) patients had a major depressive episode. The odds ratio of being diagnosed with major depressive episode was 3.86; (95% CI, 1.23-12.04) for an increase of one unit in the cluster composed by the domains of fatigue/interest and retardation, and 2.39 (95% CI, 1.21-4.71) for an increase of one unit in the cluster composed by the domains of cognitive, accessory and anxiety symptoms. The domains of eating/weight and insomnia did not contribute for the major depressive episode diagnosis.


CONCLUSIONS
The domains of retardation and interest/fatigue are the most relevant for the diagnosis of major depressive episode after stroke.
Medical School, Clinical Hospital, Institute of Psychiatry, Universidade de São Paulo, São Paulo, SP, Brazil. luisaterroni@usp.br
Luisa de Marillac Niro
Lde M
Terroni
Renério
R
Fráguas
Mara de
Md
Lucia
Gisela
G
Tinone
Patricia
P
Mattos
Dan V
DV
Iosifescu
Milberto
M
Scaf
D000328:Adult; D000368:Aged; D016000:Cluster Analysis; D003865:Major Depressive Disorder / Q000175:diagnosis*; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis*; D008297:Male; D005222:Mental Fatigue / Q000175:diagnosis*; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D020521:Stroke / Q000523:psychology*; D055815:Young Adult