Journal Article Ppublish
PubMed: 39788464 DOI: 10.1016/j.jstrokecerebrovasdis.2024.108197
Trajectory of depressive symptoms in a longitudinal stroke cohort.
J Stroke Cerebrovasc Dis 34(3):108197
Authors: Katherine Sewell, Tamara Tse, Leonid Churilov, Thomas Linden, Sheila Crewther, Henry Ma, Stephen M Davis, Geoffrey A Donnan, Leeanne M Carey
Affiliations
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Neurorehabilitation and Recovery, The Florey, Heidelberg, Australia.
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Department of Occupational Therapy, St Vincent's Hospital Melbourne, Fitzroy, Australia.
- Melbourne Medical School, University of Melbourne, Melbourne, Australia.
- Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
- Department of Neurology, Monash Medical Centre, Monash University, Melbourne, Victoria, Australia.
- Departments of Medicine and Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia.
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Neurorehabilitation and Recovery, The Florey, Heidelberg, Australia.
Abstract
OBJECTIVES
Knowledge of the trajectory of post-stroke depression is important to identify high-risk patients, develop precise management programs and enhance prognosis. We aimed to characterise the course of depressive symptoms within the first year post-stroke and to evaluate associations with time.
MATERIALS AND METHODS
Depressive symptoms were measured using the Montgomery-Åsberg Depression Rating Scale (MADRS) within the first week, and at 3 and 12 months post-stroke. Scores were dichotomised into symptoms 'present' (MADRS ≥ 7) or 'absent' (MADRS < 7). The course of depressive symptoms within individuals was mapped and categorised using a trajectory diagram. The association between time and the presence of depressive symptoms was investigated using random effects logistic regression. Logistic regression was also used to assess the likelihood of participants having depressive symptoms later, given their status at earlier time points.
RESULTS
Of 142 ischaemic stroke survivors included for analysis, almost half (47.9%) experienced a change in depressive symptom status over time. Depressive symptoms were common at each timepoint (35-43%), although an association between time and frequency of depressive symptoms was not evident. Stroke survivors with depressive symptoms at 3 months were more likely to have depressive symptoms at 12 months, compared to those without symptoms at 3 months.
CONCLUSION
Our findings provide evidence for a dynamic trajectory of depressive symptoms in individuals in the first year post-stroke. The importance of repeated screening for depression is highlighted, though most necessary at 3 months post-stroke.
MeSH
Depression, Stroke, Signs And Symptoms, Cerebrovascular Disorders