Sarfo Fred Stephen, Agbenorku Manolo, Adamu Sheila, Obese Vida, Berchie Patrick, Ovbiagele Bruce
Department of Medicine, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
J Neurol Sci. 2019 Oct 15;405:116410. doi: 10.1016/j.jns.2019.07.028. Epub 2019 Jul 23.
The very few published data on post-stroke depression (PSD) among indigenous Africans have covered its prevalence and predictors. We sought to evaluate the dynamics of PSD in a cohort of Ghanaian stroke survivors followed for 9 months after an acute stroke.
Stroke survivors in this prospective cohort were adults aged >18 years with CT scan confirmed stroke, recruited into a randomized controlled trial to assess the feasibility of an mHealth technology-enabled, nurse guided intervention for blood pressure control. PSD was assessed a secondary outcome measure using the Hamilton Depression Rating Scale (HDRS) at enrollment, months 3, 6, and 9. Those with a score of >7 points on HDRS were categorized as depressed. A multivariate logistic regression analysis was performed to identify independent predictors of PSF.
Mean age of study participants was 55.1 ± 12.7 years with 65% being males. Ischemic strokes comprised 76.6% of study population. Prevalence of PSD at baseline was 78.6%, 43.6% at month 3, 41.1% at month 6 and 18.2% at month 9 (p < .0001). Factors significantly associated with PSD at baseline were higher NIH Stoke Scale score (adjusted OR 1.51, 95% CI: 1.03-2.23) and pain (adjusted OR 7.18, 95% CI: 1.52-33.89). NIHSS score (adjusted OR, 1.99, 95% CI: 1.12-3.52) as associated with PSD at month 9.
80% Ghanaian stroke survivors have early PSD declining to 20% at month 9. Stroke severity is the persistent factor associated with PSD at baseline and follow-up, and good be a target for screening and promptly treating PSD.
关于非洲本土人群中风后抑郁（PSD）的已发表数据极少，且仅涉及患病率及预测因素。我们试图评估一组加纳中风幸存者在急性中风后9个月内PSD的动态变化情况。
该前瞻性队列研究中的中风幸存者为年龄大于18岁、经CT扫描确诊为中风的成年人，他们被纳入一项随机对照试验，以评估一项由移动健康技术支持、护士指导的血压控制干预措施的可行性。使用汉密尔顿抑郁评定量表（HDRS）在入组时、第3个月、第6个月和第9个月对PSD进行评估，将其作为次要结局指标。HDRS评分大于7分者被归类为抑郁。进行多因素逻辑回归分析以确定PSD的独立预测因素。
研究参与者的平均年龄为55.1±12.7岁，其中65%为男性。缺血性中风占研究人群的76.6%。基线时PSD的患病率为78.6%，第3个月为43.6%，第6个月为41.1%，第9个月为18.2%（p<0.0001）。与基线时PSD显著相关的因素包括较高的美国国立卫生研究院卒中量表（NIHSS）评分（调整后比值比1.51，95%置信区间：1.03 - 2.23）和疼痛（调整后比值比7.18，95%置信区间：1.52 - 33.89）。第9个月时，NIHSS评分（调整后比值比1.99，95%置信区间：1.12 - 3.52）与PSD相关。
80%的加纳中风幸存者早期患有PSD，至第9个月时降至20%。中风严重程度是基线和随访时与PSD相关的持续因素，可能是筛查和及时治疗PSD的一个靶点。
