title: Depression after stroke at 12-month follow-up: a multicenter study.
abstract: OBJECTIVE
  To study the prevalence of depression at 12 months after stroke and to analyze factors associated with depression.
  
  
  METHODS
  This prospective cross-sectional study was conducted among nine tertiary hospitals in Thailand. Stroke patients from the Thai Stroke Rehabilitation Registry who were admitted in inpatient rehabilitation wards were recruited for evaluation at the 12-month follow-up time point. Hospital Anxiety and Depression Scale (HADS) was used to evaluate depression in stroke. A score of ≥11 was considered as having depression. Univariate and multivariate analysis was used to investigate factors related with depression in stroke.
  
  
  RESULTS
  Two hundred stroke patients with a mean age of 62.1±12.5 years were recruited. Approximately 60% were male. The number of stroke patients with depression at the 12-month follow-up was 42 (21.0%, 95%CI 15.9%-27.2%). Mean HADS score at 12-month follow-up was not significantly different from those at discharge. However, 28 (16.5%) stroke patients who did not have depression at discharge developed depression during the 12-month period. From multivariate analysis, complications and urinary incontinence were found to be significantly associated with depression after stroke with adjusted odds ratio of 3.65 (95%CI 1.11-12.06) and 4.82 (95%CI 1.74-13.38), respectively.
  
  
  CONCLUSIONS
  Depression is a common complication after stroke. This study found one-fifth of stroke survivors developed depression at the 12-month follow-up. Complications at discharge and urinary incontinence were significantly correlated with depression in multivariate analysis. Further study concerning interventions in decreasing depression should be performed in order to improve the quality of life of those stroke patients.
authors.affiliation: a Division of Rehabilitation Psychology and Recreation, Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.
authors.forename: Patchara
authors.initials: P
authors.lastname: Limampai
authors.affiliation: b Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.
authors.forename: Wanpen
authors.initials: W
authors.lastname: Wongsrithep
authors.affiliation: b Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.
authors.forename: Vilai
authors.initials: V
authors.lastname: Kuptniratsaikul
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation / Q000523:psychology; D013785:Thailand / Q000453:epidemiology
keywords: HADS; Stroke; depression; rehabilitation