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Depressive Disorders in Long-Term Survivors of Stroke

Associations with Demographic and Social Factors, Functional Status, and Brain Lesion Volume

Published online by Cambridge University Press:  02 January 2018

Michael Sharpe*
Affiliation:
University Department of Psychiatry, Oxford
Keith Hawton
Affiliation:
Warneford Hospital and University Department of Psychiatry, Oxford
Valerie Seagroatt
Affiliation:
Unit of Clinical Epidemiology, Department of Clinical Epidemiology and Primary Care, University of Oxford, Oxford
John Bamford
Affiliation:
St James University Hospital, Beckett Street, Leeds
Allan House
Affiliation:
Department of Psychological Medicine, Leeds General Infirmary, Leeds
Andrew Molyneux
Affiliation:
Department of Radiology, Radcliffe Infirmary, Oxford
Peter Sandercock
Affiliation:
Department of Clinical Neurosciences, Western General Hospital, Edinburgh
Charles Warlow
Affiliation:
Department of Clinical Neurosciences, Western General Hospital, Edinburgh
*
University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX

Abstract

Sixty surviving patients from a community-based stroke register who had computerised tomography (CT) scan evidence of a single brain lesion were interviewed three to five years after their first ever stroke. Depression (DSM–III–R major depression, partially resolved major depression, and dysthymia) was present in 11 (18%) of the patients and was associated with impaired physical and cognitive functioning, greater age, residence in an institution, absence of a close personal relationship, and larger original brain lesion. Of these variables, only functional dependence (odds ratio 16.4; confidence interval 1.6–170), larger lesion volume (6.6; 1–50), and female sex (8; 1.1–56) remained significantly associated with depression after controlling for all other variables. We conclude that depression in long-term survivors of stroke has many of the same associations as depression in non-stroke elderly populations. Depression in long-term stroke survivors may also be associated with larger original brain lesions, although this requires confirmation in a prospective study.

Type
Peer Review
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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