Stress and depression scales in aphasia: relation between the aphasia depression rating scale, stroke aphasia depression questionnaire-10, and the perceived stress scale

Abstract

Background Assessment and diagnosis of post-stroke depression (PSD) among patients with aphasia presents unique challenges. A gold-standard assessment of PSD among this population has yet to be identified. Objectives The first aim was to investigate the association between two depression scales developed for assessing depressive symptoms among patients with aphasia. The second aim was to evaluate the relation between these scales and a measure of perceived stress. Method Twenty-five (16 male; 9 female) individuals with history of left-hemisphere cerebrovascular accident (CVA) were assessed for depression and perceived stress using the Stroke Aphasic Depression Questionnaire-10 (SADQ-10), the Aphasia Depression Rating Scale (ADRS), and the Perceived Stress Scale (PSS). Results SADQ-10 and ADRS ratings were strongly correlated with each other (r = 0.708, p < 0.001). SADQ-10 ratings were strongly correlated with PSS ratings (r = 0.620, p = 0.003), while ADRS ratings were moderately correlated (r = 0.492, p = 0.027). Item analysis of each scale identified items which increased both inter-scale correlation and intra-scale consistency when excluded. Conclusions The SADQ-10 and ADRS appear to be acceptable measures of depressive symptoms in aphasia patients. Measurements of perceived stress may also be an important factor in assessment of depressive symptoms.

Post Stroke Depression

“…The symptoms that make the diagnosis of poststroke depression the most difficult are aphasia, anosognosia, neglect, abulia and cognitive disabilities that result from their stroke [37]. Unfortunately, the majority of studies that evaluate poststroke depression exclude patients with these symptoms.…”

“…This is largely due to their inability to answer questions, fill out questionnaires, or because it is difficult for medical staff to assign a score to the patient based on their daily interactions. Aphasia is independently associated with an increased risk of developing poststroke depression [37]. However, three scales have been developed to assess depression in aphasic patients.…”

“…The (SADQ/SADQ-10/SADQH-10) and the Aphasia Depression Rating Scale are based on the observation of other people to determine if the patient being assessed is in fact depressed or not. The SADQ-10 used caregivers as the observers, with non-aphasic patients as the controls [37]. A value of 14/30 or higher was correlated with the development of depression and depressive symptoms with a sensitivity of 70% and specificity of 77%.…”

“…The ADRS scoring system used external signs that could be observed such as fatigue, insomnia, changes in weight, and signs of anxiety. A score of 9/30 or higher was associated with the development of depression with a sensitivity of 83% and specificity of 71% [37]. After a comparative analysis, it was determined that either one of these tools could be used for assessing depression in aphasic patients.…”

“…Due to the severity of their post-stroke symptoms these patients may be at increased risk of death due to complications like pneumonia secondary to dysphasia or infection from decubitus ulcers. Another hypothesis is that patients that are suffering from poststroke depression may be less likely to be compliant with medical recommendations, such as healthy diet, avoiding tobacco, alcohol, drug use, scheduled follow up appointments and medication compliance [37,38]. These factors can increase the risk of mortality.…”