Factors Affecting Post-Stroke Depression in Acute Ischemic Stroke Patients after 3 Months

Abstract

Post-stroke depression (PSD) affects approximately one-third of stroke patients. PSD not only impairs recovery and lowers quality of life, but has also serious neurological consequences, high mortality, and stroke recurrence risks. Studies on PSD-related prognostic factors are still lacking, especially environmental factors. Moreover, relieving factors after PSD in stroke patients has not been reported. This study aimed to investigate (study design 1) risk factors for PSD diagnosis after three months, and (study design 2) related factors for the relieving of early PSD after three months. This retrospective study included 227 patients hospitalized for acute ischemic stroke within three days at Jeonbuk National University Hospital from January to December 2019. The depressive status was assessed using the Hamilton Depression Rating Scale (HDRS) at admission and after three months. Clinical and laboratory data were analyzed for relevant prognostic factors. (Study design 1) HDRS score at admission (adjusted odds ratio (aOR) 1.22, 95% confidence interval (CI) 1.14–1.31; p < 0.001) and hospitalization period (aOR 1.11, 95% CI 1.02–1.20; p = 0.013) were confirmed as prognostic factors of PSD after three months. (Study design 2) The National Institute of Health Stroke Scale (NIHSS) score at discharge (aOR 0.80, 95% CI 0.68–0.94; p = 0.006) and HDRS score at admission (aOR 0.80, 95% CI 0.71–0.89; p < 0.001) were confirmed as prognostic factors of depression improvement after three months. In conclusion, environmental factors such as hospitalization period could be important in managing PSD. Factors related to PSD improvement are expected to be helpful in establishing a strategy for PSD recovery.

The etiologies of post-stroke depression: Different between lacunar stroke and non-lacunar stroke

“… 27 , 28 , 29 PSD after lacunar and non-lacunar stroke shared some common risk factors, such as female gender, degrees of neurological deficits and functional outcome, which had been studied and identified as the predictors of PSD for a series of studies. 29 , 30 , 31 , 32 , 33 , 34 Meanwhile, there were also some risk factors associated with PSD after lacunar stroke and non-lacunar stroke differently. For example, the unfavorable treatment effect was associated with PSD after lacunar stroke more strongly.…”

Effect of acupuncture combined with antidepressants on post-stroke depression: A network meta-analysis of nine acupuncture therapy

“…Post-stroke depression (PSD) is a psychological disorder characterized by persistent depression, decreased interest and behavioral withdrawal after stroke ( 1 , 2 ). The main manifestations are psychiatric symptoms, such as insomnia, depression and low self-esteem, and even suicidal tendencies, which can lead to cognitive impairment ( 3 , 4 ).…”