Depression predicts unfavourable functional outcome and higher mortality in stroke patients: the Bergen Stroke Study.
OBJECTIVE
To assess the influence of depression prior to stroke (PD) on stroke severity on admittance, functional outcome (short- and long-term), mortality, and long-term depression (PSD).


METHODS
Consecutive acute stroke patients were screened for PD. The National Institute of Health Stroke Scale score was obtained on admission. Short-term functional state was registered by the modified Rankin scale and on long-term functional outcome by the Barthel Index. PSD was defined as depression subscale of the hospital anxiety and depression scale (HADSD) >or=11. HADSD and Barthel Index were obtained by postal questionnaire. Survival analyses were performed.


RESULTS
Among 771 patients 21.7% had PD. Among 376 patients returning the questionnaire, 8.8% were depressed. On logistic regression analyses severity of stroke on admission, short-term, and long-term functional outcome were independently associated with PD. Logistic regression showed PSD to be independently associated with PD and being unmarried. Cox regression analyses showed that both PD and PSD were associated with high long-term mortality.


CONCLUSIONS
This study has identified several factors associated with PSD. PD predicts more severe stroke on admittance and less functional improvement both in the short- and the long-term. Both PD and PSD predict higher long-term mortality.
Naess
H
H
Department of Neurology, Haukeland University Hospital, Bergen, Norway. halvor.naess@haukeland.no
Lunde
L
L
Brogger
J
J
Waje-Andreassen
U
U
D000368:Aged; D015897:Comorbidity / Q000639:trends; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D009026:Mortality / Q000639:trends; D009664:Norway / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000379:methods; D011237:Predictive Value of Tests; D015995:Prevalence; D012720:Severity of Illness Index; D020521:Stroke / Q000401:mortality* / Q000523:psychology; D011795:Surveys and Questionnaires / Q000592:standards