Nolte C H, Müller-Nordhorn J, Jungehülsing G J, Rossnagel K, Reich A, Roll S, Laumeier I, Beerfelde D, Willich S N, Villringer A
Klinik und Poliklinik für Neurologie der Charite-Universitätsmedizin in Berlin.
Fortschr Neurol Psychiatr. 2006 May;74(5):251-6. doi: 10.1055/s-2005-919144. Epub 2006 Feb 16.
Many patients develop a depression after having suffered a stroke. Such a Post-Stroke Depression (PSD) impairs rehabilitation and quality of life. PSD is underdiagnosed in spite of available treatment. Several questionnaires have been created to diagnose a PSD. But questionnaires have been considered cumbersome and time-consuming. The aim of this study was to find out whether two simple, standardised questions will identify those stroke patients, who have developed a PSD.
The two case-finding questions and the Beck Depression Inventory (BDI) were sent to patients of the Berlin Acute Stroke Study (BASS) four years after their stroke. Incomplete questionnaires were complemented via mail or telephone. Severity of depression was assessed by means of BDI.
Out of 211 patients, 199 responded to the questionnaire (94 %). 193 questionnaires were complete (97 %). Forty-two patients affirmed both case-finding questions (22 %). Compared to patients, who did not affirm both questions, these patients had a higher BDI score (19 +/- 8 vs. 7 +/- 5; p < 0.001). The sensitivity and specificity of the two questions were 89 % and 90 %, respectively. The positive and negative predictive value were 60 % and 98 % respectively. The number of confirmed questions (0, 1, 2) correlated well with the BDI score (r (2) = 0.67, p < 0.001).
Two standardized questions can identify patients with PSD for further diagnostic evaluation and therapy. Diagnosis of PSD might be facilitated by using them as screening instrument.
许多患者在中风后会患上抑郁症。这种中风后抑郁症（PSD）会损害康复进程和生活质量。尽管有可用的治疗方法，但PSD仍未得到充分诊断。已经创建了几份问卷来诊断PSD。但问卷被认为繁琐且耗时。本研究的目的是确定两个简单、标准化的问题是否能识别出患有PSD的中风患者。
在中风四年后，将这两个病例发现问题和贝克抑郁量表（BDI）发送给柏林急性中风研究（BASS）的患者。不完整的问卷通过邮件或电话进行补充。通过BDI评估抑郁的严重程度。
在211名患者中，199名对问卷做出了回应（94%）。193份问卷完整（97%）。42名患者对两个病例发现问题都给予肯定回答（22%）。与未对两个问题都给予肯定回答的患者相比，这些患者的BDI得分更高（19±8 vs. 7±5；p<0.001）。这两个问题的敏感性和特异性分别为89%和90%。阳性预测值和阴性预测值分别为60%和98%。确认问题的数量（0、1、2）与BDI得分密切相关（r(2)=0.67，p<0.001）。
两个标准化问题可以识别出患有PSD的患者，以便进行进一步的诊断评估和治疗。将它们用作筛查工具可能有助于PSD的诊断。
