title: Evolution of depression symptoms following stroke: a prospective study using computerized ambulatory monitoring.
abstract: BACKGROUND
  Despite the high prevalence and impact of post-stroke depression (PSD), questions persist concerning the nature and stability of PSD over time. The current study uses state-of-the-art computerized ambulatory monitoring techniques to assess daily life depression symptoms following stroke and examines the evolution of depression levels over a three-month period.
  
  
  METHODS
  48 patients admitted to a university hospital neurology unit for ischemic or hemorrhagic stroke participated in ambulatory monitoring of DSM-IV depression symptoms for a one-week period after hospital discharge. Clinician-administered measures of depression were also obtained at discharge and again three months later.
  
  
  RESULTS
  The percentage of the sample with elevated depression scores was the same at discharge and three months later, but consistency in depression profiles was low. Ambulatory monitoring revealed that elevated depression levels at hospital discharge were most strongly associated with anhedonia (t ratio = 4.840, p < 0.001) and fatigue (t ratio = 4.00, p < 0.001), whereas individuals with elevated scores at three months were predicted by daily life negative thoughts (t ratio = 4.051, p < 0.001), anxious mood (t ratio = 3.489, p < 0.01), sad mood (t ratio = 2.621, p < 0.05) and emotional reactivity (t ratio = 2.466, p < 0.05).
  
  
  CONCLUSIONS
  The prevalence of depression may appear stable during the immediate weeks and months following stroke, but it is likely to be composed of very different symptom profiles. The immediate physical and psychological impact of stroke may induce somatic symptoms that explain elevated depression levels and which may not indicate a risk factor for later depression.
authors.affiliation: University of Bordeaux, National Center for Scientific Research (INCIA, CNRS 5287), Bordeaux, France.
authors.forename: Igor
authors.initials: I
authors.lastname: Sibon
authors.forename: Saioa
authors.initials: S
authors.lastname: Lassalle-Lagadec
authors.forename: Pauline
authors.initials: P
authors.lastname: Renou
authors.forename: Joel
authors.initials: J
authors.lastname: Swendsen
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods*; D015995:Prevalence; D011446:Prospective Studies; D020521:Stroke / Q000150:complications* / Q000523:psychology; D013997:Time Factors