title: Depression improvement is related to social role functioning after stroke.
abstract: OBJECTIVE
  To (1) examine the relationships between baseline demographic, clinical, and psychological characteristics and social role functioning (SRF) at 4 months after stroke, and (2) assess whether depression improvement is associated with 4-month SRF.
  
  
  METHODS
  We completed a secondary data analysis using data from a completed cohort study including people with stroke with or without depression. We used multiple linear regression to identify variables independently associated with 12-week SRF.
  
  
  METHODS
  Hospital and patients' homes. The intervention was via phone calls.
  
  
  METHODS
  People with a new stroke recruited during the inpatient stay (N=371, depressed only n=176). All survived an ischemic stroke, were 18 years and older, spoke and understood English, owned a telephone, had no severe language or cognitive impairments, and were expected to live at least 6 months.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  We measured depression with the Patient Health Questionnaire-9 (PHQ-9), and depression improvement was defined by a 50% decrease in PHQ-9 scores from baseline to 12 weeks or a 12-week PHQ-9 score <10. SRF was measured with the social domain of the Stroke-Specific Quality of Life Scale.
  
  
  RESULTS
  Depression and comorbidities were found to be independently associated with 12-week SRF. Importantly, depression response (or depression improvement) was the only variable to independently predict SRF in the depressed-only group.
  
  
  CONCLUSIONS
  Among stroke survivors with depression, improvement of that depression was independently associated with improved SRF. This is a reminder of the importance for rehabilitation providers to screen for and treat poststroke depression.
authors.affiliation: Roudebush Veterans Administration Medical Center, Health Services Research and Development Center on Implementing Evidence-Based Practice, Indianapolis, IN 46202, USA. arlene.schmid@va.gov
authors.forename: Arlene A
authors.initials: AA
authors.lastname: Schmid
authors.forename: Teresa
authors.initials: T
authors.lastname: Damush
authors.forename: Wanzhu
authors.initials: W
authors.lastname: Tu
authors.forename: Tamilyn
authors.initials: T
authors.lastname: Bakas
authors.forename: Kurt
authors.initials: K
authors.lastname: Kroenke
authors.forename: Hugh C
authors.initials: HC
authors.lastname: Hendrie
authors.forename: Linda S
authors.initials: LS
authors.lastname: Williams
mesh_terms: D000203:Activities of Daily Living; D017677:Age Distribution; D000368:Aged; D016208:Databases, Factual; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D026741:Physical Therapy Modalities; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018434:Sickness Impact Profile; D012917:Social Adjustment; D020521:Stroke / Q000150:complications / Q000523:psychology*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D017741:Survivors; D016896:Treatment Outcome