Kim Eun-Song, Kim Ju-Wan, Kang Hee-Ju, Bae Kyung-Yeol, Kim Sung-Wan, Kim Joon-Tae, Park Man-Seok, Cho Ki-Hyun, Kim Jae-Min
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea.
Psychiatry Investig. 2018 Feb;15(2):141-146. doi: 10.30773/pi.2017.10.11. Epub 2017 Oct 30.
Stroke is associated with significant long-term morbidity and poor quality of life (QOL). Depression is one of the most common complications after stroke and has been associated with QOL cross-sectionally. We investigated the longitudinal impact of depression in the acute phase of stroke on QOL 1 year after stroke.
In total, 423 patients were evaluated 2 weeks after stroke, and 288 (68%) were followed 1 year later. QOL was assessed using the World Health Organization Quality of Life-Abbreviated form (WHOQOL-BREF) at baseline and follow-up. Depression was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders-IV criteria; demographic and clinical characteristics data, including stroke severity, were obtained at baseline. The longitudinal associations of post-stroke depression (PSD) at baseline with QOL across two evaluation points were assessed using a repeated-measures analysis of variance.
The WHOQOL-BREF scores were significantly and persistently lower 1 year after stroke in patients with PSD at baseline compared with those without PSD at baseline independent of demographic and clinical characteristics, including stroke severity.
PSD in the acute phase of stroke is an independent predictor of QOL in both the acute and chronic phases of stroke. Our findings underscore the importance of evaluating depression in the acute phase of stroke.
中风与严重的长期发病及生活质量(QOL)低下相关。抑郁症是中风后最常见的并发症之一,且与生活质量的横断面研究有关。我们调查了中风急性期抑郁症对中风后1年生活质量的纵向影响。
总共423例患者在中风后2周接受评估,1年后对288例(68%)进行随访。在基线和随访时使用世界卫生组织生活质量简表(WHOQOL-BREF)评估生活质量。根据《精神障碍诊断与统计手册》第四版标准诊断抑郁症;在基线时获取人口统计学和临床特征数据,包括中风严重程度。使用重复测量方差分析评估基线时中风后抑郁症(PSD)与两个评估点生活质量的纵向关联。
与基线时无PSD的患者相比,基线时有PSD的患者在中风1年后,无论人口统计学和临床特征(包括中风严重程度)如何,WHOQOL-BREF评分均显著且持续较低。
中风急性期的PSD是中风急性期和慢性期生活质量的独立预测因素。我们的研究结果强调了在中风急性期评估抑郁症的重要性。