Mpembi Nkosi M, Mampunza Ma Miezi S, Massamba Kubuta V, Matonda Ma Nzuzi T, Dubois V, De Partz M-P, Peeters A, Macq J, Constant E
Département de psychiatrie, université catholique de Louvain, institut de recherche santé publique, santé et société, place de l'Université 1, 1348 Louvain-La-Neuve, Belgique; Département de psychiatrie, université de Kinshasa, Lemba, Kinshasa, Congo.
Département de psychiatrie, université de Kinshasa, Lemba, Kinshasa, Congo.
Rev Neurol (Paris). 2014 Oct;170(10):614-20. doi: 10.1016/j.neurol.2014.03.002. Epub 2014 May 20.
To describe the evolution of the clinical profile of post-stroke depression over a period of one year and to determine factors associated with changes in post-stroke depression.
Prospective cohort study with a follow-up of 1year including 30 consecutive eligible patients. The severity of depression was assessed with the patient health questionnaire (PHQ9).
The mean age was 55.87±12.67years. Seventy percent of patients were men. The two assessments for neurological status, perceived health status and test results of attention were not statistically different. The rate of depressive symptoms was 26.67% in 2011 and 20% in 2012. Disability and apathy were significantly improved. The average for disability increased from 2.77±1.19 to 2.46±2.19 (P=0.002). From 66.7% in 2011, the proportion of patients able to walk without assistance rose to 93.3% in 2012 (P=0.03). In addition, the proportion of patients apathetic decreased from 43.3% to 13.3% (P=0.01). Greater age, female sex, sleep disorders and post-stroke apathy remained associated with DPAVC between the two assessments, with an increase in the strength of the association for apathy.
The frequency of post-stroke depression is high and remains stable over time. Disability is the clinical feature that evolved more favorably. The association with apathy, present at the beginning, of the study was strengthened one year later.
描述卒中后抑郁临床特征在一年时间内的演变情况,并确定与卒中后抑郁变化相关的因素。
前瞻性队列研究,随访1年,纳入30例连续符合条件的患者。采用患者健康问卷(PHQ9)评估抑郁严重程度。
平均年龄为55.87±12.67岁。70%的患者为男性。两次评估的神经学状态、感知健康状态和注意力测试结果无统计学差异。2011年抑郁症状发生率为26.67%,2012年为20%。残疾和冷漠症状有显著改善。残疾平均评分从2.77±1.19提高到2.46±2.19(P = 0.002)。能够独立行走的患者比例从2011年的66.7%升至2012年的93.3%(P = 0.03)。此外,冷漠患者比例从43.3%降至13.3%(P = 0.01)。在两次评估之间,年龄较大、女性、睡眠障碍和卒中后冷漠仍与抑郁严重程度的变化相关,且冷漠的关联强度增加。
卒中后抑郁发生率较高且随时间保持稳定。残疾是改善最明显的临床特征。研究开始时存在的与冷漠的关联在一年后增强。