title: The influence of depressive symptoms on quality of life after stroke: a prospective study.
abstract: BACKGROUND
  Poststroke depressive symptoms have prospectively predicted impairment of health-related quality of life (HRQOL). However, it is not known whether such predictive effect is independent of HRQOL at 1 month after stroke. This study aimed to investigate the impact of depressive symptoms at 1 and 3 months after stroke on the 3-month poststroke HRQOL and to investigate the influence of the HRQOL measured at 1 month after stroke on these relationships.
  
  
  METHODS
  We prospectively evaluated 67 patients at 1 and 3 months after a first-ever ischemic stroke from 106 eligible patients who have been consecutively admitted to the neurology ward of a teaching hospital. A psychiatrist assessed the presence of depressive symptoms using the 31-item version of the Hamilton Rating Scale for Depression and the HRQOL was assessed with the 36-item Short-Form Health Survey from the Medical Outcomes Study. We used linear regression to measure the impact of depressive symptoms, HRQOL at 1 month, and potential confounders on HRQOL at 3 months.
  
  
  RESULTS
  We found an association between depressive symptoms at 1 month and HRQOL at 3 months after the stroke; however, this association was not significant when adjusting for the 1 month poststroke HRQOL. Depressive symptoms at 3 months were associated with HRQOL at 3 months after stroke, independently of the poststroke HRQOL at 1 month and potential confounders.
  
  
  CONCLUSIONS
  Current depressive symptoms at 3 months are important for HRQOL at 3 months after stroke; however, regarding the prospective prediction, HRQOL at 1 month is the most relevant factor.
authors.affiliation: Division of Psychology, Central Institute, Clinical Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil. Electronic address: valeriguajardo@yahoo.com.br.
authors.forename: Valeri Delgado
authors.initials: VD
authors.lastname: Guajardo
authors.affiliation: Consultation Psychiatric Group, Department and Institute of Psychiatry, University of São Paulo, School of Medicine, São Paulo, Brazil.
authors.forename: Luisa
authors.initials: L
authors.lastname: Terroni
authors.affiliation: Consultation Psychiatric Group, Department and Institute of Psychiatry, University of São Paulo, School of Medicine, São Paulo, Brazil.
authors.forename: Matildes de Freitas Menezes
authors.initials: Mde F
authors.lastname: Sobreiro
authors.affiliation: Consultation Psychiatric Group, Department and Institute of Psychiatry, University of São Paulo, School of Medicine, São Paulo, Brazil.
authors.forename: Maria Irene dos Santos
authors.initials: MI
authors.lastname: Zerbini
authors.affiliation: Department of Neurology, Clinical Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Gisela
authors.initials: G
authors.lastname: Tinone
authors.affiliation: Department of Neurology, Clinical Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Milberto
authors.initials: M
authors.lastname: Scaff
authors.affiliation: Mood and Anxiety Disorders Program at Mount Sinai School of Medicine, New York.
authors.forename: Dan V
authors.initials: DV
authors.lastname: Iosifescu
authors.affiliation: Division of Psychology, Central Institute, Clinical Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Mara Cristina Souza
authors.initials: MC
authors.lastname: de Lucia
authors.affiliation: Consultation Psychiatric Group, Department and Institute of Psychiatry, University of São Paulo, School of Medicine, São Paulo, Brazil.
authors.forename: Renério
authors.initials: R
authors.lastname: Fráguas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications / Q000523:psychology; D003863:Depression / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011788:Quality of Life; D012959:Socioeconomic Factors; D020521:Stroke / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Stroke; depression; prospective study; quality of life