Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
Department of Neurology, Qingdao Eighth People's Hospital, Qingdao, Shandong, 266000, China.
BMC Neurol. 2024 Aug 15;24(1):286. doi: 10.1186/s12883-024-03744-7.
Post-stroke depression (PSD) is closely associated with poor stroke prognosis. However, there are some challenges in identifying and assessing PSD. This study aimed to identify scales for PSD diagnosis, assessment, and follow-up that are straightforward, accurate, efficient, and reproducible.
A systematic literature search was conducted in 7 electronic databases from January 1985 to December 2023.
Thirty-two studies were included, the Patient Health Questionnaire-9 (PHQ-9) and Hamilton Depression Scale (HDRS) had higher diagnostic accuracy for PSD. The sensitivity, specificity, and diagnostic odds ratio of PHQ-9 or diagnosing any depression were 0.82, 0.87, and 29 respectively. And for HDRS, used for diagnosing major depression, the scores were 0.92, 0.89, and 94. Furthermore, these two scales also had higher diagnostic accuracy in assessing depressive symptoms during both the acute and chronic phases of stroke. In patients with post-stroke aphasia and cognitive impairment, highly diagnostic scales have not been identified for assessing depressive symptoms yet.
The PHQ-9 and HDRS scales are recommended to assess PSD. HDRS, which demonstrates high diagnostic performance, can replace structured interviews based on diagnostic criteria.
脑卒中后抑郁（PSD）与不良的脑卒中预后密切相关。然而，在识别和评估 PSD 方面存在一些挑战。本研究旨在确定简单、准确、高效和可重复的 PSD 诊断、评估和随访量表。
系统检索了 1985 年 1 月至 2023 年 12 月 7 个电子数据库中的文献。
共纳入 32 项研究，PHQ-9 和 HDRS 对 PSD 的诊断准确性较高。PHQ-9 或任何抑郁诊断的灵敏度、特异度和诊断优势比分别为 0.82、0.87 和 29；HDRS 用于诊断重度抑郁症的得分分别为 0.92、0.89 和 94。此外，这两种量表在评估脑卒中急性期和慢性期的抑郁症状时也具有较高的诊断准确性。对于脑卒中后失语和认知障碍的患者，尚未确定评估抑郁症状的高度诊断量表。
推荐使用 PHQ-9 和 HDRS 量表评估 PSD。HDRS 具有较高的诊断性能，可以替代基于诊断标准的结构化访谈。
