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 Citing Articles via Scopus Google Scholar Articles by Turner-Stokes, L. Articles by Hassan, N. Search for Related Content PubMed PubMed Citation Articles by Turner-Stokes, L. Articles by Hassan, N. Pubmed/NCBI databases Medline Plus Health Information Stroke Social Bookmarking                   What's this?

Depression after stroke: a review of the evidence base to inform the development of an integrated care pathway. Part 1: Diagnosis, frequency and impact

Nibras Hassan

Northwick Park and St Mark's Hospital Trust, Harrow, Middlesex, UK

Background: Depression is a common complication of stroke, leading to increased morbidity and mortality. It can impede the process of rehabilitation, and has been associated with poorer outcomes and increased length of stay in hospital. This systematic review was undertaken as a preliminary step to explore the available evidence on which to base an integrated care pathway (ICP) for the management of post-stroke depression (PSD) in a rehabilitation setting. It is divided into two parts.

Aims and objectives: In part 1 we review the frequency of depression in stroke and its impact on functional recovery. Also the different methods for diagnosis and measurement.

Methods: Data sources comprised a computer-aided search of published studies on depression in stroke and references to literature used in reviews.

Main findings: PSD is common and is associated with cognitive, functional and social deficits which potentially limit the outcome from rehabilitation. However, diversity of assessment tools and diagnostic criteria confound assimilation of the available literature. The Beck Depression Inventory (BDI), Hamilton Depression Rating Scale and Zung Self-rating Depression Scale were most commonly used and have demonstrable validity in stroke patients but tend to exclude those with aphasia. Instruments developed specifically to include aphasic patients, such as the Stroke Aphasic Depression Scale, are promising but have yet to be fully evaluated.

Conclusions: Further work is required to adapt and evaluate instruments to measure depression in the context of stroke. Development of an integrated care pathway may help to establish a more consistent approach to assessment and diagnosis of PSD.

Clinical Rehabilitation, Vol. 16, No. 3, 231-247 (2002)
DOI: 10.1191/0269215502cr487oa


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

This article has been cited by other articles:

				M. M. Nelson, M. A. Smith, B. C. Martinson, A. Kind, and R. V. Luepker Declining Patient Functioning and Caregiver Burden/Health: The Minnesota Stroke Survey-Quality of Life After Stroke Study Gerontologist, October 1, 2008; 48(5): 573 - 583. [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]

				A. M. Knottnerus, T. Turner-Stokes, F.B. van de Weg, L. Heijnen, G.J. Lankhorst, and L. Turner-Stokes Diagnosis and treatment of depression following acquired brain injury: a comparison of practice in the UK and the Netherlands Clinical Rehabilitation, September 1, 2007; 21(9): 805 - 811. [Abstract] [PDF]

				B. D. Thombs, G. Magyar-Russell, E. B. Bass, K. J. Stewart, K. K. Tsilidis, D. E. Bush, J. A. Fauerbach, U. D. McCann, and R. C. Ziegelstein Performance Characteristics of Depression Screening Instruments in Survivors of Acute Myocardial Infarction: Review of the Evidence Psychosomatics, June 1, 2007; 48(3): 185 - 194. [Abstract] [Full Text] [PDF]

				L Turner-Stokes, M Kalmus, D Hirani, and F Clegg The Depression Intensity Scale Circles (DISCs): a first evaluation of a simple assessment tool for depression in the context of brain injury J. Neurol. Neurosurg. Psychiatry, September 1, 2005; 76(9): 1273 - 1278. [Abstract] [Full Text] [PDF]

				R. RUDDY and A. HOUSE Meta-review of high-quality systematic reviews of interventions in key areas of liaison psychiatry The British Journal of Psychiatry, August 1, 2005; 187(2): 109 - 120. [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, 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]