van Mierlo Maria L, van Heugten Caroline M, Post Marcel W, de Kort Paul L, Visser-Meily Johanna M
Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands.
Arch Phys Med Rehabil. 2015 Jun;96(6):1064-70. doi: 10.1016/j.apmr.2015.01.022. Epub 2015 Feb 12.
To identify psychological factors related to poststroke depressive symptoms.
Cross-sectional study, with patients assessed at 2 months poststroke.
Patients with stroke from 6 general hospitals.
Stroke patients (N=344; mean age ± SD, 66.9±12.3y).
Not applicable.
The presence of clinical depressive symptoms was determined with the depression subscale of the Hospital Anxiety and Depression Scale 2 months poststroke. Psychological factors assessed were extraversion, neuroticism, optimism, pessimism, self-efficacy, helplessness, acceptance, perceiving benefits, proactive coping, and passive coping.
Bivariate correlations and multivariate backward logistic regression were used to analyze associations between psychological factors and poststroke depressive symptoms, accounting for demographic and stroke-related factors. More neuroticism, pessimism, passive coping, and helplessness, and less extraversion, optimism, self-efficacy, acceptance, perceived benefits, and proactive coping were bivariately associated with the presence of depressive symptoms. Multivariate logistic regression analysis showed that more helplessness (odds ratio [OR]=1.17) and passive coping (OR=1.19) and less acceptance (OR=.89) and perceived benefits (OR=.89) were independently significantly associated with the presence of poststroke depressive symptoms (Nagelkerke R(2)=.49).
We found a relationship between psychological variables and the presence of depressive symptoms 2 months poststroke. It is important to take these factors into account during poststroke rehabilitation.
确定与中风后抑郁症状相关的心理因素。
横断面研究,对中风后2个月的患者进行评估。
6家综合医院的中风患者。
中风患者(N = 344;平均年龄±标准差,66.9±12.3岁)。
不适用。
在中风后2个月,使用医院焦虑抑郁量表的抑郁分量表确定临床抑郁症状的存在。评估的心理因素包括外向性、神经质、乐观、悲观、自我效能感、无助感、接受度、感知益处、积极应对和消极应对。
采用双变量相关性分析和多变量向后逻辑回归分析心理因素与中风后抑郁症状之间的关联,并考虑人口统计学和中风相关因素。双变量分析显示,更多的神经质、悲观、消极应对和无助感,以及更少的外向性、乐观、自我效能感、接受度、感知益处和积极应对与抑郁症状的存在相关。多变量逻辑回归分析表明,更多的无助感(优势比[OR]=1.17)和消极应对(OR = 1.19),以及更少的接受度(OR = 0.89)和感知益处(OR = 0.89)与中风后抑郁症状的存在独立显著相关(Nagelkerke R² = 0.49)。
我们发现心理变量与中风后2个月抑郁症状的存在之间存在关联。在中风后康复过程中考虑这些因素很重要。