title: Clinical Manifestation of Depression after Stroke: Is It Different from Depression in Other Patient Populations?
abstract: BACKGROUND
  Despite ample research on depression after stroke, the debate continues regarding whether symptoms such as sleep disturbances, loss of energy, changes in appetite and diminished concentration should be considered to be consequences of stroke or general symptoms of depression. By comparing symptoms in depressed and non-depressed stroke patients with patients in general practice and patients with symptomatic atherosclerotic diseases, we aim to further clarify similarities and distinctions of depression after stroke and depression in other patient populations. Based on this, it is possible to determine if somatic symptoms should be evaluated in stroke patients in diagnosing depression after stroke.
  
  
  METHODS
  An observational multicenter study is conducted in three hospitals and seven general practices including 382 stroke patients admitted to hospital with a clinical diagnosis of intracerebral hemorrhage or ischemic infarction, 1160 patients in general practice (PREDICT-NL), and 530 patients with symptomatic atherosclerotic diseases (SMART-Medea).
  
  
  RESULTS
  The prevalence of major depressive disorder according to DSM-IV criteria was 14.1% (95% CI 11.0%-18.0%) in the stroke cohort, 5.4% (95% CI 3.8%-7.9%) in the symptomatic atherosclerotic diseases cohort and 12.9% (95% CI 11.1%-15.0%) in the general practice cohorts. Comparing depressed patients of the three cohorts demonstrated broadly similar symptom profiles, as well as comparable levels of individual symptom prevalence. However, the stroke patients suffered more severely from these symptoms than patients in the other populations.
  
  
  CONCLUSIONS
  The findings suggest that depression after stroke is not a different type of depression. This finding indicates that all depressive symptoms should be evaluated in stroke patients, including somatic symptoms.
authors.affiliation: Department of Rehabilitation, Nursing Science and Sports, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.|Nursing Science, program in Clinical Health Sciences University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Janneke M
authors.initials: JM
authors.lastname: de Man-van Ginkel
authors.affiliation: Department of Rehabilitation, Nursing Science and Sports, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.|Nursing Science, program in Clinical Health Sciences University Medical Center Utrecht, Utrecht, The Netherlands.|University of Professional Education Utrecht, Department of Healthcare, Utrecht, The Netherlands.|Faculty of Nursing, University of Iceland, Reykjavik, Iceland.
authors.forename: Thóra B
authors.initials: TB
authors.lastname: Hafsteinsdóttir
authors.affiliation: Department of Rehabilitation, Nursing Science and Sports, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.|Centre of Excellence for Rehabilitation Medicine, Rehabilitation Center 'De Hoogstraat', The Netherlands.
authors.forename: Eline
authors.initials: E
authors.lastname: Lindeman
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Mirjam I
authors.initials: MI
authors.lastname: Geerlings
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.affiliation: Department of Rehabilitation, Nursing Science and Sports, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.|Nursing Science, program in Clinical Health Sciences University Medical Center Utrecht, Utrecht, The Netherlands.|University of Professional Education Utrecht, Department of Healthcare, Utrecht, The Netherlands.
authors.forename: Marieke J
authors.initials: MJ
authors.lastname: Schuurmans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000209:etiology / Q000473:pathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000473:pathology / Q000523:psychology*