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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 ,
Keith Hawton ,
Valerie Seagroatt ,
John Bamford ,
Allan House ,
Andrew Molyneux ,
Peter Sandercock  and
Charles Warlow
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
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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
Information
The British Journal of Psychiatry , Volume 164 , Issue 3 , March 1994 , pp. 380 - 386
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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References

Aho, K., Harmsen, P., Hatano, S., et al (1980) Cerebrovascular disease in the community; results of a WHO collaborative study. WHO Bulletin, 58, 113–130.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Baker, R. J. & Nelder, J. A. (1978) The Generalised Linear Interactive Modelling System (Release 3). Oxford: Oxford Numerical Algorithms Group.Google Scholar
Bamford, J., Sandercock, P., Dennis, M., et al (1988) A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project 1981–86.1. Methodology, demography and incident cases of first-ever stroke. Journal of Neurology, Neurosurgery and Psychiatry, 51, 1373–1380.Google Scholar
Bamford, J., Sandercock, P., et al (1990) A prospective study of acute cerebrovascular disease in the community. Journal of Neurology, Neurosurgery and Psychiatry, 53, 16–22.Google Scholar
Blazer, D. (1989) Depression in the elderly. New England Journal of Medicine, 320, 164–166.Google Scholar
Dam, H., Pederson, H. E. & Ahlgren, P. (1989) Depression among patients with stroke. Acta Psychiatrica Scandinavica, 80, 118–124.CrossRefGoogle ScholarPubMed
Eastwood, M. R., Rifat, S. L., Nobbs, H., et al (1989) Mood disorder following cerebrovascular accident. British Journal of Psychiatry, 154, 195–200.CrossRefGoogle ScholarPubMed
Enderby, P. M., Wood, V. A., Wade, D. T., et al (1987) The Frenchay Aphasia Screening Test: A short simple test for aphasia suitable for non-specialists. International Journal of Rehabilitation Medicine, 8, 166–170.CrossRefGoogle Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) Mini-Mental State. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Holbrook, M. & Skilbeck, C. E. (1983) An activities index for use with stroke patients. Age and Aging, 12, 166–170.Google Scholar
House, A. (1987) Mood disorders after stroke: a review of the evidence. International Journal of Geriatric Psychiatry, 2, 211–221.Google Scholar
House, A. Dennis, M., Warlow, C., et al (1990) The relationship between intellectual impairment and mood disorder in the first year after stroke. Psychological Medicine, 20, 805–814.Google Scholar
House, A. Dennis, M., Mogridge, L., et al (1991) Mood disorders in the year after first stroke. British Journal of Psychiatry, 158, 83–92.Google Scholar
Johnson, G. A. (1991) Research into psychiatric disorder after stroke: the need for further studies. Australian and New Zealand Journal of Psychiatry, 25, 358–370.CrossRefGoogle ScholarPubMed
Koenig, H. G., Meador, K. G., Cohen, H. J., et al (1988) Depression in elderly hospitalized patients with medical illness. Archives of Internal Medicine, 142, 1929–1936.Google Scholar
Mahoney, F. & Barthel, D. (1965) Functional evaluation: the Barthel Index. Maryland State Medical Journal, 14, 61–65.Google Scholar
Mayou, R. A., Seagroatt, V. & Goldacre, M. (1991) Use of psychiatric services by patients in a general hospital. British Medical Journal, 303, 1029–1032.Google Scholar
Murphy, E. (1982) Social origins of depression in old age. British Journal of Psychiatry, 141, 135–142.CrossRefGoogle ScholarPubMed
Nieme, M., Laaksonen, R., Kotila, M., et al (1988) Quality of life 4 years after stroke. Stroke, 19, 1101–1107.Google Scholar
Parikh, R. M., Lipsey, J. R., Robinson, R. G., et al (1988) A two year longitudinal study of poststroke mood disorders: prognostic factors related to one and two year outcomes. International Journal of Psychiatry in Medicine, 18, 45–56.CrossRefGoogle Scholar
Parikh, R. M., Robinson, R. G., Lipsey, J. R., et al (1990) The impact of poststroke depression on recovery in activities of daily living over a 2-year follow-up. Archives of Neurology, 47, 785–789.CrossRefGoogle ScholarPubMed
Pullicino, P., Nelson, R. F., Kendall, B. E., et al (1980) Small deep infarcts diagnoses on computed tomography. Neurology, 30, 1090–1096.CrossRefGoogle ScholarPubMed
Reifler, B. V., Larson, E. & Hanley, R. (1982) Coexistence of cognitive impairment and depression in geriatric outpatients. American Journal of Psychiatry, 139, 623–626.Google Scholar
Robinson, R. G., Kubos, K. L., Starr, L. B., et al (1983) Mood changes in stroke patients: relationship to lesion location. Comprehensive Psychiatry, 24, 556–566.Google Scholar
Robinson, R. G., Starr, L. B., Kubos, K. L., et al (1983) A two year evaluation of post-stroke mood disorders: findings during the initial evaluation. Stroke, 14, 736–741.CrossRefGoogle ScholarPubMed
Robinson, R. G., Kubos, K. L., Starr, L. B., et al (1984a) Mood disorders in stroke patients: importance of location of lesion. Brain, 107, 81–93.Google Scholar
Robinson, R. G., Starr, L. B. & Price, T. R. (1984b) A two year longitudinal study of mood disorders following stroke: prevalence and duration at six months follow-up. British Journal of Psychiatry, 144, 256–262.Google Scholar
Schwartz, J. A., Speed, N. M., Mountz, J. M., et al (1990) 99mTc-hexamethylpropyleneamine oxime single photon emission CT in poststroke depression. American Journal of Psychiatry, 147, 242–244.Google Scholar
Sharpe, M., Hawton, K., House, A., et al (1990) Mood disorders in long-term survivors of stroke: associations with brain lesion location and volume. Psychological Medicine, 20, 815–828.Google Scholar
Sinyor, D., Jacques, P., Kaloupek, D. G., et al (1986) Poststroke depression and lesion location. An attempted replication. Brain, 109, 537–546.Google Scholar
Spitzer, R. L., Williams, J. B. & Gibbon, M. (1986) Instruction Manual for the Structured Clinical Interview for DSM–III–R. New York: Biometrics Research Department, New York State Psychiatric Institute.Google Scholar
Starkstein, S. E., Robinson, R. G., Berthier, M. L., et al (1988) Depressive disorders following posterior circulation as compared with middle cerebral artery infarcts. Brain, 111, 375–387.Google Scholar
Starkstein, S. E., Robinson, R. G., (1989) Affective disorders and cerebral vascular disease. British Journal of Psychiatry, 154, 170–182.Google Scholar
Wade, D. T., Legh Smith, J. & Hewer, R. A. (1987) Depressed mood after stroke. A community study of its frequency. British Journal of Psychiatry, 151, 200–205.Google Scholar
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