Loong C K, Kenneth N K, Paulin S T
Department of Rehabilitative Medicine, Tan Tock Seng Hospital, Singapore.
Aust N Z J Psychiatry. 1995 Dec;29(4):609-14. doi: 10.3109/00048679509064975.
This prospective study looks at the outcome of rehabilitation on mood and physical recovery in patients with post-stroke depression.
Fifty-two patients in a rehabilitation centre were assessed for depression, modified Barthel's score and Hamilton Rating Scale for depression on admission to and discharge from the rehabilitation centre. Aphasic, demented and delirious patients were excluded.
Fifty-five percent of the patients were assessed to have depression on admission and 98% had physical impairment. At the time of discharge, only 28.6% were depressed and two-thirds had improved in physical function. Patients with all degrees of functional impairment showed equal improvement and there was no difference between Barthel's scores for patients whose mood improved and those who remained depressed. There were very strong associations between functional assessment and depression, functional assessment on discharge with depression on admission, and patients' mood on admission and discharge. Depressed patients did not stay longer in the rehabilitation centre than non-depressed patients. Low doses of anti-depressants did not have an impact on mood or functional improvement.
We have found that depression might not have a clear negative impact on rehabilitation, that mood improved at the end of rehabilitation and that the degree of depression on admission was a good predictor of the outcome of final physical impairment.
本前瞻性研究旨在观察中风后抑郁症患者康复对情绪和身体恢复的效果。
对康复中心的52名患者在入院和出院时进行抑郁评估、改良巴氏评分及汉密尔顿抑郁量表评估。失语、痴呆和谵妄患者被排除。
55%的患者入院时被评估为患有抑郁症，98%有身体损伤。出院时，只有28.6%的患者仍有抑郁，三分之二患者的身体功能得到改善。所有功能障碍程度的患者改善程度相同，情绪改善患者与仍有抑郁患者的巴氏评分无差异。功能评估与抑郁、出院时功能评估与入院时抑郁、患者入院和出院时的情绪之间存在非常强的关联。抑郁患者在康复中心的停留时间并不比非抑郁患者长。低剂量抗抑郁药对情绪或功能改善没有影响。
我们发现抑郁症可能对康复没有明显的负面影响，康复结束时情绪有所改善，入院时的抑郁程度是最终身体损伤结果的良好预测指标。
