Yang Song-ran, Hua Ping, Shang Xin-yuan, Hu Rong, Mo Xiao-en, Pan Xiao-ping
BMC Psychiatry. 2013 Jun 5;13:164. doi: 10.1186/1471-244X-13-164.
Apathy and depression are important neuropsychiatric disorders that can occur after a stroke but the etiology and risk factors are not well understood. The purpose of this study was to identify risk factors for apathy and depression following a stroke.
Patients with an acute stroke who met the inclusion criteria were recruited from our hospital, and general information was recorded from patient charts. The Apathy Evaluation Scale, Clinician Version (AES-C) was used to evaluate these patients within 2 weeks after the stroke. The Montreal Cognitive Assessment (MoCA), mini-mental state examination (MMSE), Hamilton Depression Scale (HAMD), Mattis Dementia Rating Scale Initiation/Perseveration subset (MDRS I/P), Frontal Assessment Battery (FAB) and Stroop Color-Word Association Test were employed to evaluate emotion, cognitive function and executive function. The patients were divided into two groups: the apathy group and the non-apathy group. We also divided the patients into two groups based on whether or not they had post-stroke depression. The clinical characteristics and scores on the MoCA, MMSE, HAMD and MDRS I/P were compared between the apathy and non-apathy groups as well as between patients with and without depression. Logistic regression analysis was performed to identify risk factors for apathy and depression following a stroke.
A total of 75 patients with acute stroke were recruited. Of these, 25 (33.3%) developed apathy and 12 (16%) developed depression. Multivariate logistic regression analysis indicated that a history of cerebrovascular disease (OR: 6.45, 95% CI: 1.48-28.05, P = 0.013), low HbA1c (OR: 0.31, 95% CI: 0.12-0.81, P = 0.017) and a low MDRS I/P score (OR: 0.84, 95% CI: 0.74, 0.96, P = 0.010) were risk factors for post-stroke apathy. Additionally, multivariate logistic regression indicated that a low MDRS I/P (OR: 0.85, 95% CI: 0.75, 0.97, P = 0.015) was associated with post-stroke depression.
Three risk factors for post-stroke apathy were identified as a history of cerebrovascular disease, low HbA1c and lower MDRS I/P scores. A low MDRS I/P score was also identified as a risk factor for post-stroke depression. These results may be useful to clinicians in recognizing and treating apathy and depression in patients after a stroke.
冷漠和抑郁是中风后可能出现的重要神经精神障碍，但病因和危险因素尚不清楚。本研究的目的是确定中风后冷漠和抑郁的危险因素。
从我院招募符合纳入标准的急性中风患者，并从患者病历中记录一般信息。在中风后2周内使用临床医生版冷漠评估量表（AES-C）对这些患者进行评估。采用蒙特利尔认知评估量表（MoCA）、简易精神状态检查表（MMSE）、汉密尔顿抑郁量表（HAMD）、马蒂斯痴呆评定量表启动/持续性子集（MDRS I/P）、额叶评估量表（FAB）和斯特鲁普颜色-词语联想测验来评估情绪、认知功能和执行功能。将患者分为两组：冷漠组和非冷漠组。我们还根据患者是否患有中风后抑郁将其分为两组。比较冷漠组和非冷漠组以及有抑郁和无抑郁患者的临床特征和MoCA、MMSE、HAMD及MDRS I/P评分。进行逻辑回归分析以确定中风后冷漠和抑郁的危险因素。
共招募了75例急性中风患者。其中，25例（33.3%）出现冷漠，12例（16%）出现抑郁。多因素逻辑回归分析表明，脑血管疾病史（OR：6.45，95%CI：1.48 - 28.05，P = 0.013）、低糖化血红蛋白（HbA1c）（OR：0.31，95%CI：0.12 - 0.81，P = 0.017）和低MDRS I/P评分（OR：0.84，95%CI：0.74，0.96，P = 0.010）是中风后冷漠的危险因素。此外，多因素逻辑回归表明，低MDRS I/P（OR：0.85，95%CI：0.75，0.97，P = 0.015）与中风后抑郁有关。
确定了中风后冷漠的三个危险因素为脑血管疾病史、低HbA1c和较低的MDRS I/P评分。低MDRS I/P评分也被确定为中风后抑郁的危险因素。这些结果可能有助于临床医生识别和治疗中风后患者的冷漠和抑郁。
