Premium
Clinical depression is associated with impaired recovery from stroke
Author(s) -
Morris Philip L P,
Raphael Beverley,
Robinson Robert G
Publication year - 1992
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1992.tb137126.x
Subject(s) - depression (economics) , stroke (engine) , medicine , activities of daily living , stroke recovery , cohort , cognition , physical therapy , psychiatry , rehabilitation , mechanical engineering , engineering , economics , macroeconomics
Objective To examine the effect of clinical depression on recovery from stroke. Method We examined a cohort of inpatients with stroke initially at two months after their stroke and again 14 months later. Patients were included if they: (i) provided informed consent; (ii) were able to understand the interview questions; and (iii) survived to follow‐up without suffering another stroke or major medical illness. Of 61 consecutive patients, 49 met these criteria. Depression was diagnosed using a structured clinical interview. Three aspects of recovery were measured: (i) functional status; (ii) activities of daily living; and (iii) cognitive performance. Results Twenty (41%) of the 49 patients were depressed at initial assessment. There were no significant differences in demographic, clinical, stroke or lesion characteristics between the depressed and non‐depressed patients. At follow‐up, depressed patients improved less than non‐depressed patients in functional status (mean change from baseline, 23% versus 48%) ( P =0.001) and cognitive performance (–1% versus 11%) ( P = 0.096). Mean recovery in activities of daily living was not different between the two groups (33% versus 32%) but more of the depressed patients deteriorated over time (20% versus 0%) ( P = 0.047). Conclusion Clinical depression occurring soon after stroke is associated with impaired recovery when patients are assessed 14 months later. Depression has a negative effect on recovery in functional status and cognitive performance and may produce deterioration in physical capacity in a number of patients. Physicians would be well advised to be alert for depression and intervene early. Effective treatment of depression may enhance stroke rehabilitation.