Post-stroke depression:: Predictive factors at one year follow-up

Introduction. The presence of depression constitutes one of the treatable complications in stroke survivors. Its long term prevalence and the triggering factors are unknown in our community. Moreover, its presence can interfere in the process of rehabilitating the patient and in family dynamics. Patients and methods. A sample of 118 patients from the Stroke Unit at the Hospital Universitario San Carlos in Madrid were studied. After one year follow-up, 90 survivors (41 females and 49 males; average age: 68 years) were evaluated, with their informed consent, with the Hamilton depression and Beck's melancholia scale, the Barthel index, the Rankin scale, Psychosocial Dimension of Sickness Impact Profile and the Scandinavian neurological scale. A factorial ANOVA model was used to conduct the statistical analysis. Results. On discharge, a third of the patients presented symptoms of depression, while a year after the stroke the figure had risen to 67%. The average score on the Hamilton scale at one year follow-up was 13.1 and was rated as mild depression. The variables related with depression one year after the stroke were of a socio-demographic nature (female, women working in the home, long-lasting occupational disability; p < 0.0001), whereas biological variables (cortical/subcortical distribution, laterality, aetiology and subtype of the stroke) were not statistically significant. Subjects suffering from serious disabilities that affected the performance of their daily activities (Barthel < 60) scored significantly worse (p = 0.005). Motor deficit, according to the Scandinavian scale, was of no use as a predictor of depression one year after the stroke (n = 0.0617). Conclusions. Post-stroke depression is highly prevalent in our community and, late on in the follow-up, is associated with socio-demographic variables and with the degree of disability.