title: The relationship between post-stroke depression and physical recovery.
abstract: BACKGROUND
  Post-stroke depression (PSD) is a serious and common complication of stroke. In this prospective study on the relationship between clinical PSD and physical recovery, we focused on (1) distinguishing between depression and apathy, (2) issues in assessment of PSD, and (3) timing of assessment.
  
  
  METHODS
  Japanese stroke patients (n=117) were studied. We used self-rating scales [Zung Self-Rating Depression Scale (SDS) for depression; Apathy Scale (AS) for apathy] and observer-rating scales [Montgomery-Åsberg Depression Rating Scale (MADRS) for depression; Neuropsychiatric Inventory-Nursing Home (NPI-NH) for apathy] to assess psychological state. We assessed physical disability using the Functional Independence Measurement (FIM). Two-way analysis of covariance was used to determine effects of depression and apathy on functional outcome. We evaluated PSD twice, within 10 days after hospitalization and four weeks later.
  
  
  RESULTS
  Objective scales gave higher prevalence than subjective scales for both depression and apathy. A significant effect of apathy on FIM recovery was seen with objective scale assessment during hospitalization; there was a marginal effect of depression at the same time.
  
  
  CONCLUSIONS
  We did not consider the stroke size and location. In addition, we excluded patients with severe comprehension deficits or with a history of stroke.
  
  
  CONCLUSIONS
  Our findings indicate that depression and apathy could occur independently after stroke and could individually influence functional recovery. We obtained more accurate estimates of functional recovery using objective measures. Furthermore, our findings suggest that depression and apathy should be assessed not only at admission but also during hospitalization to estimate and enhance the functional recovery of stroke patients.
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
authors.forename: Shiho
authors.initials: S
authors.lastname: Matsuzaki
authors.affiliation: Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan. Electronic address: m-hashi@kumamoto-u.ac.jp.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Yuki
authors.affiliation: Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Asuka
authors.initials: A
authors.lastname: Koyama
authors.affiliation: Kumamoto Takumadai Rehabilitation Hospital, Kumamoto, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Hirata
authors.affiliation: Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Ikeda
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D020127:Recovery of Function; D020521:Stroke / Q000453:epidemiology* / Q000523:psychology*
keywords: Apathy; Depression; Physical recovery; Post-stroke depression; Rehabilitation