Early Depression Screening Is Feasible in Hospitalized Stroke Patients

Abstract

Background and PurposePost-stroke depression (PSD) is common but is not routinely assessed for in hospitalized patients. As a Comprehensive Stroke Center, we screen all stroke inpatients for depression, though the feasibility of early screening has not been established. We assessed the hypothesis that early depression screening in stroke patients is feasible. We also explored patient level factors associated with being screened for PSD and the presence of early PSD.MethodsThe medical records of all patients admitted with ischemic stroke (IS) or intracerebral hemorrhage (ICH) between 01/02/13 and 15/04/13 were reviewed. A depression screen, modified from the Patient Health Questionnaire-9, was administered (maximum score 27, higher scores indicating worse depression). Patients were eligible if they did not have a medical condition precluding screening. Feasibility was defined as screening 75% of all eligible patients.ResultsOf 303 IS and ICH inpatients, 70% (211) were eligible for screening, and 75% (158) of all eligible patients were screened. More than one-third of all patients screened positive for depression (score > 4). Women (OR 2.06, 95% CI 1.06–4.01) and younger patients (OR 0.97, 95% CI 0.96–0.99) were more likely to screen positive. Screening positive was not associated with poor discharge/day 7 outcome (mRS > 3; OR 1.45, 95% CI 0.74–2.83).ConclusionsScreening stroke inpatients for depression is feasible and early depression after stroke is common. Women and younger patients are more likely to experience early PSD. Our results provide preliminary evidence supporting continued screening for depression in hospitalized stroke patients.

Risk factors for post-stroke depression in Sohag University Hospital

“…Contrary to our results, it was reported that patients under 50 years old occupy a higher percentage of subjects with depression [23]. Also, it was recognized that younger patients appear to be more attentive about the prognosis of the disease [4,25].…”

“…Its prevalence was evaluated to be from 20 to 65%, contingent upon the population studied, the assessment tools, and the defining criteria of depression [3]. Post-stroke depression (PSD) is associated with more physical disability, particularly in day by day activities, poor functional outcome, and high death rate [4].…”

Association between inflammatory cytokines and the risk of post-stroke depression, and the effect of depression on outcomes of patients with ischemic stroke in a 2-year prospective study

“…However, it was observed that patients <50 years of age occupy a larger proportion of patients with depression. In the authors' clinical work, it was identified that younger patients appear to be more concerned about the prognosis of the disease (33,34). The factors that have an important role in the psychological state of younger patients requires further study.…”

Implementing and feasibility testing depression screening using the electronic medical record for patients with type 2 diabetes admitted to the hospital

“…One of the providers who responded to the survey contemplated the possibility of “false positive screens” among hospitalized patients due to physical symptoms. However, previous studies (Karamchandani et al, ; Wagner et al, ) supported the feasibility and acceptability of depression screening in hospitalized patients using different screening tools, including the PHQ‐9, the screening tool used in this study (Kroenke et al, ).…”