Guajardo Valeri Delgado, Terroni Luisa, Sobreiro Matildes de Freitas Menezes, Zerbini Maria Irene dos Santos, Tinone Gisela, Scaff Milberto, Iosifescu Dan V, de Lucia Mara Cristina Souza, Fráguas Renério
Division of Psychology, Central Institute, Clinical Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil.
Consultation Psychiatric Group, Department and Institute of Psychiatry, University of São Paulo, School of Medicine, São Paulo, Brazil.
J Stroke Cerebrovasc Dis. 2015 Jan;24(1):201-9. doi: 10.1016/j.jstrokecerebrovasdis.2014.08.020. Epub 2014 Nov 12.
Poststroke depressive symptoms have prospectively predicted impairment of health-related quality of life (HRQOL). However, it is not known whether such predictive effect is independent of HRQOL at 1 month after stroke. This study aimed to investigate the impact of depressive symptoms at 1 and 3 months after stroke on the 3-month poststroke HRQOL and to investigate the influence of the HRQOL measured at 1 month after stroke on these relationships.
We prospectively evaluated 67 patients at 1 and 3 months after a first-ever ischemic stroke from 106 eligible patients who have been consecutively admitted to the neurology ward of a teaching hospital. A psychiatrist assessed the presence of depressive symptoms using the 31-item version of the Hamilton Rating Scale for Depression and the HRQOL was assessed with the 36-item Short-Form Health Survey from the Medical Outcomes Study. We used linear regression to measure the impact of depressive symptoms, HRQOL at 1 month, and potential confounders on HRQOL at 3 months.
We found an association between depressive symptoms at 1 month and HRQOL at 3 months after the stroke; however, this association was not significant when adjusting for the 1 month poststroke HRQOL. Depressive symptoms at 3 months were associated with HRQOL at 3 months after stroke, independently of the poststroke HRQOL at 1 month and potential confounders.
Current depressive symptoms at 3 months are important for HRQOL at 3 months after stroke; however, regarding the prospective prediction, HRQOL at 1 month is the most relevant factor.
卒中后抑郁症状已被前瞻性地预测会损害健康相关生活质量(HRQOL)。然而,尚不清楚这种预测作用是否独立于卒中后1个月时的HRQOL。本研究旨在调查卒中后1个月和3个月时的抑郁症状对卒中后3个月时HRQOL的影响,并调查卒中后1个月时测量的HRQOL对这些关系的影响。
我们对一家教学医院神经科病房连续收治的106例符合条件的患者中的67例首次缺血性卒中患者在卒中后1个月和3个月进行了前瞻性评估。一位精神科医生使用汉密尔顿抑郁评定量表31项版本评估抑郁症状的存在情况,并使用医疗结局研究的36项简短健康调查问卷评估HRQOL。我们使用线性回归来测量抑郁症状、1个月时的HRQOL以及潜在混杂因素对3个月时HRQOL的影响。
我们发现卒中后1个月时的抑郁症状与3个月时的HRQOL之间存在关联;然而,在对卒中后1个月时的HRQOL进行校正后,这种关联并不显著。卒中后3个月时的抑郁症状与卒中后3个月时的HRQOL相关,独立于卒中后1个月时的HRQOL和潜在混杂因素。
卒中后3个月时当前的抑郁症状对卒中后3个月时的HRQOL很重要;然而,就前瞻性预测而言,卒中后1个月时的HRQOL是最相关的因素。