Park Geun-Young, Im Sun, Lee Soo-Jung, Pae Chi-Un
Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Psychiatry Investig. 2016 Nov;13(6):659-664. doi: 10.4306/pi.2016.13.6.659. Epub 2016 Nov 24.
This study evaluated the association between post-stroke depression (PSD) and clinical outcomes, including activities of daily living (ADL) and gait balance, in patients with first-onset stroke. One hundred and eighty inpatients were recruited and followed-up for a 6-month. The depressive, cognitive, and stroke symptoms were assessed using the Beck Depression Inventory (BDI), the Global Deterioration Scale (GDS), the modified Rankin Scale (MRS), and the Berg Balance Scale (BBS). All patients were assessed at baseline and at the end of the observation (6-month). Among 180 patients, 127 (70.6%) were diagnosed with minimal-to-mild depression (MMD) while 53 (29.4%) were diagnosed with moderate-to-severe depression (MSD). The odd ratio (OR) for poor outcome in the MSD group was approximately 3.7 relative to the MMD group. The proportion of patients with better balance classified by the BBS score at 6-month was significantly higher in the MMD group than in the MSD group (OR=1.375). Our findings demonstrate the potential relationship between PSD and rehabilitation outcomes measured by different rating scales in Korean stroke patients. Our study suggests that clinicians should carefully evaluate depressive symptoms in patients with stroke during routine clinical practice. Adequately-powered and well-controlled further studies are necessary to confirm and fully characterize this relationship.
本研究评估了首次发生卒中的患者中，卒中后抑郁（PSD）与临床结局之间的关联，这些临床结局包括日常生活活动能力（ADL）和步态平衡。招募了180名住院患者并进行为期6个月的随访。使用贝克抑郁量表（BDI）、总体衰退量表（GDS）、改良Rankin量表（MRS）和伯格平衡量表（BBS）对抑郁、认知和卒中症状进行评估。所有患者在基线和观察结束时（6个月）均进行评估。在180名患者中，127名（70.6%）被诊断为轻度至中度抑郁（MMD），而53名（29.4%）被诊断为中度至重度抑郁（MSD）。相对于MMD组，MSD组不良结局的比值比（OR）约为3.7。MMD组中6个月时根据BBS评分分类为平衡较好的患者比例显著高于MSD组（OR=1.375）。我们的研究结果表明了韩国卒中患者中PSD与通过不同评定量表测量的康复结局之间的潜在关系。我们的研究提示临床医生在日常临床实践中应仔细评估卒中患者的抑郁症状。需要进行有足够样本量和良好对照的进一步研究来证实并充分描述这种关系。
