Kellermann M, Fekete I, Gesztelyi R, Csiba L, Kollár J, Sikula J, Bereczki D
Department of Neurology, University Medical School of Debrecen, Hungary.
Gen Hosp Psychiatry. 1999 Mar-Apr;21(2):116-21. doi: 10.1016/s0163-8343(98)00067-x.
Depressive symptoms can often be observed after stroke. We prospectively evaluated patients at a stroke unit in order to determine the occurrence and severity of depressive symptoms in the acute phase of stroke in 82 patients 7 +/- 2 days after admission to the stroke unit. Severity of stroke was evaluated by the Scandinavian and Orgogozo scales and the Barthel index. Severity of depressive symptoms was measured by the 13-item Beck scale. Mean age of the patients was 65.8 years. No gender difference was observed in the severity of stroke or depressive symptoms. DSM-IV criteria of adjustment disorder with depressed mood were fulfilled by 27% of the patients. In this group, stroke was significantly more severe by the Barthel, Orgogozo, and Scandinavian scales (p < 0.001). Whereas Beck score was at least 10 in 19.5%, severe depressive symptoms (Beck score > or = 15) occurred in less than 5% of patients with acute stroke. Those who could not walk by themselves or who were aphasic had significantly higher mean Beck scores (6.3 +/- 5.1 vs 2.4 +/- 3.1, p < 0.001, and 7.0 +/- 5.8 vs 3.4 +/- 3.9, p = 0.002). Significant correlation was found between the severity of stroke and that of the depressive symptoms (r = -0.56, -0.58, and -0.54 for the Scandinavian, Orgogozo, and Barthel scales, p < 0.001).
中风后常常可以观察到抑郁症状。我们对一家中风单元的患者进行了前瞻性评估,以确定82例患者在入住中风单元7±2天后的急性期抑郁症状的发生情况和严重程度。中风严重程度通过斯堪的纳维亚量表、奥尔戈佐量表和巴氏指数进行评估。抑郁症状的严重程度通过13项贝克量表进行测量。患者的平均年龄为65.8岁。在中风严重程度或抑郁症状方面未观察到性别差异。27%的患者符合DSM-IV中伴有抑郁情绪的适应障碍标准。在这组患者中,根据巴氏量表、奥尔戈佐量表和斯堪的纳维亚量表,中风明显更严重(p<0.001)。虽然贝克评分至少为10分的患者占19.5%,但严重抑郁症状(贝克评分≥15分)在急性中风患者中发生率不到5%。那些不能独立行走或失语的患者平均贝克评分显著更高(分别为6.3±5.1对2.4±3.1,p<0.001;7.0±5.8对3.4±3.9,p = 0.002)。发现中风严重程度与抑郁症状严重程度之间存在显著相关性(斯堪的纳维亚量表、奥尔戈佐量表和巴氏量表的r分别为-0.56、-0.58和-0.54,p<0.001)。