Kulkantrakorn Kongkiat, Jirapramukpitak Tawanchai
Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Klong Luang, Pathumtani, 12120, Thailand.
J Neurol Sci. 2007 Dec 15;263(1-2):165-8. doi: 10.1016/j.jns.2007.07.014. Epub 2007 Jul 25.
Stroke patients were recruited after their first diagnosis and PD patients were recruited during the same recruitment period. Main measures included: 1) disability (Barthel Index and Modified Rankin Scale), 2) cognitive function (Thai Mental State Examination and 3) depression (Clinical Interview Schedule-Revised). The patients were assessed at 1, 2, 3, 6 and 12 months.
Seventy-seven stroke patients with hemispheric infarction and 59 PD patients were recruited. The baseline characteristics of the two groups were comparable except that stroke patients were 4 years younger. The cumulative one year incidence of depression was 12% after stroke and 5.1% in PD with no significant difference. Cox regression analysis showed that the risk for depression among stroke cohort was almost three times higher, although not statistically significant, than that among PD cohort (hazard ratio 2.92). In stroke, depression mainly occurred within 3 months after the event but in PD, depression developed randomly throughout the follow up period.
The one year cumulative incidence of post-stroke depression in the Thai population is much lower than in the Caucasian population. However, its adjusted cumulative incidence was much higher to that of PD. The findings are in line with previous studies that stroke significantly contributes to the pathogenesis of depression.
1)测量缺血性中风事件后抑郁症的一年累积发病率,2)在门诊神经科将其发病率与帕金森病(PD)的发病率进行比较。
中风患者在首次诊断后招募,PD患者在同一招募期间招募。主要测量指标包括:1)残疾程度(Barthel指数和改良Rankin量表),2)认知功能(泰国精神状态检查),3)抑郁情况(修订版临床访谈时间表)。患者在1、2、3、6和12个月时接受评估。
招募了77例半球梗死的中风患者和59例PD患者。两组的基线特征具有可比性,只是中风患者年龄小4岁。中风后抑郁症的一年累积发病率为12%,PD为5.1%,无显著差异。Cox回归分析显示,中风队列中抑郁症的风险几乎是PD队列的三倍,尽管无统计学意义(风险比2.92)。在中风患者中,抑郁症主要发生在事件后的3个月内,但在PD患者中,抑郁症在整个随访期间随机发生。
泰国人群中中风后抑郁症的一年累积发病率远低于白种人群。然而,其调整后的累积发病率远高于PD。这些发现与先前的研究一致,即中风对抑郁症的发病机制有显著影响。