This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by van de Weg, F B Articles by Lankhorst, G J Search for Related Content PubMed PubMed Citation Articles by van de Weg, F B Articles by Lankhorst, G J Social Bookmarking                   What's this?

Post-stroke depression and functional outcome: a cohort study investigating the influence of depression on functional recovery from stroke

Rehabilitation Centre, Amsterdam, The Netherlands

D J Kuik

Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, The Netherlands

G J Lankhorst

Department of Rehabilitation Medicine, University Hospital Vrije Universiteit, Amsterdam, The Netherlands

Objective: To investigate the influence of depression on functional recovery after stroke.

Design: Multicentre cohort study of 85 patients admitted for clinical rehabilitation. A two-stage case-finding procedure was used to identify patients with depression. For the control group, consecutive nondepressed stroke patients were enrolled. Patients were interviewed at 3–6 weeks and six months after stroke onset.

Setting: Three rehabilitation centres in the vicinity of Amsterdam.

Main outcome measures: Functional outcome was determined by the Functional Independence Measure (FIM) and the Rehabilitation Activities Profile (RAP).

Results: The prevalence of depression (35%) was comparable with the findings of earlier studies in other settings. Patients classified as depressed according to DSM III R criteria (American Psychiatric Association Diagnostic and statistical manual of mental disorders) had a significantly lower functional score, both at onset and after follow-up (FIM and RAP). There was, however, no significant difference in functional improvement between the depressed and the nondepressed group. Mean functional improvement in the six patients treated with antidepressants was 30% better than in the untreated (depressed) patients; numbers were too small for the results to attain statistical significance. Subset analysis showed a significantly higher outcome for nondepressed patients for the FIM subitems personal care and transfers. However, functional improvement was not significantly different for any of the subitems in depressed versus nondepressed patients.

Conclusion: Stroke patients with depression have significantly lower functional scores both at onset and after six months. Our results suggest under-recognition of post-stroke depression and a possible beneficial effect of antidepressant medication in depressed stroke patients. Further studies are required to determine the effect of antidepressants.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J. Verhoef, P. Toussaint, H. Putter, J. Zwetsloot-Schonk, and T. Vliet Vlieland Validity and responsiveness of the Rehabilitation Activities Profile (RAP) in patients with rheumatoid arthritis Clinical Rehabilitation, September 1, 2008; 22(9): 788 - 800. [Abstract] [PDF]

				S. A. Thomas and N. B. Lincoln Predictors of Emotional Distress After Stroke Stroke, April 1, 2008; 39(4): 1240 - 1245. [Abstract] [Full Text] [PDF]

				S. Hart and R. Morris Screening for depression after stroke: an exploration of professionals' compliancewith guidelines Clinical Rehabilitation, January 1, 2008; 22(1): 60 - 70. [Abstract] [PDF]

				S. L. Wolf, C. J. Winstein, J. P. Miller, S. Blanton, P. C. Clark, and D. Nichols-Larsen Looking in the Rear View Mirror When Conversing With Back Seat Drivers: The EXCITE Trial Revisited Neurorehabil Neural Repair, October 1, 2007; 21(5): 379 - 387. [Abstract] [PDF]

				C Donnellan, D Hevey, A Hickey, and D O'Neill Defining and quantifying coping strategies after stroke: a review. J. Neurol. Neurosurg. Psychiatry, November 1, 2006; 77(11): 1208 - 1218. [Abstract] [Full Text] [PDF]

				M. L. Hackett, C. Yapa, V. Parag, and C. S. Anderson Frequency of Depression After Stroke: A Systematic Review of Observational Studies Stroke, June 1, 2005; 36(6): 1330 - 1340. [Abstract] [Full Text] [PDF]

				L Leeds, R J Meara, and J P Hobson The utility of the Stroke Aphasia Depression Questionnaire (SADQ) in a stroke rehabilitation unit Clinical Rehabilitation, February 1, 2004; 18(2): 228 - 231. [Abstract] [PDF]

				S. L Morris, K. J Dodd, and M. E Morris Outcomes of progressive resistance strength training following stroke: a systematic review Clinical Rehabilitation, January 1, 2004; 18(1): 27 - 39. [Abstract] [PDF]

				D. C. Steffens, K. R. R. Krishnan, C. Crump, and G. L. Burke Cerebrovascular Disease and Evolution of Depressive Symptoms in the Cardiovascular Health Study Stroke, June 1, 2002; 33(6): 1636 - 1644. [Abstract] [Full Text] [PDF]

				N. Hassan, L. Turner-Stokes, K. Pierce, and F. Clegg A completed audit cycle and integrated care pathway for the management of depression following brain injury in a rehabilitation setting Clinical Rehabilitation, May 1, 2002; 16(5): 534 - 540. [Abstract] [PDF]

				L. Turner-Stokes and N. Hassan Depression after stroke: a review of the evidence base to inform the development of an integrated care pathway. Part 1: Diagnosis, frequency and impact Clinical Rehabilitation, March 1, 2002; 16(3): 231 - 247. [Abstract] [PDF]

				L. Turner-Stokes and N. Hassan Depression after stroke: a review of the evidence base to inform the development of an integrated care pathway. Part 2: Treatment alternatives Clinical Rehabilitation, March 1, 2002; 16(3): 248 - 260. [Abstract] [PDF]

				L. Turner-Stokes, N. Hassan, K. Pierce, and F. Clegg Managing depression in brain injury rehabilitation: the use of an integrated care pathway and preliminary report of response to sertraline Clinical Rehabilitation, March 1, 2002; 16(3): 261 - 268. [Abstract] [PDF]

				E. J. Lenze, J. C. Rogers, L. M. Martire, B. H. Mulsant, B. L. Rollman, M. A. Dew, R. Schulz, and C. F. Reynolds III The Association of Late-Life Depression and Anxiety With Physical Disability: A Review of the Literature and Prospectus for Future Research Am J Geriatr Psychiatry, May 1, 2001; 9(2): 113 - 135. [Abstract] [Full Text]

				P. W. Duncan, H. S. Jorgensen, and D. T. Wade Outcome Measures in Acute Stroke Trials : A Systematic Review and Some Recommendations to Improve Practice Stroke, June 1, 2000; 31(6): 1429 - 1438. [Abstract] [Full Text] [PDF]