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Clinical Trial
. 2015 Dec 4;10(12):e0144450.
doi: 10.1371/journal.pone.0144450. eCollection 2015.

Clinical Manifestation of Depression after Stroke: Is It Different from Depression in Other Patient Populations?

Janneke M de Man-van Ginkel  1   2 , Thóra B Hafsteinsdóttir  1   2   3   4 , Eline Lindeman  1   5 , Mirjam I Geerlings  6 , Diederick E Grobbee  6 , Marieke J Schuurmans  1   2   3
Affiliations
Clinical Trial

Clinical Manifestation of Depression after Stroke: Is It Different from Depression in Other Patient Populations?

Janneke M de Man-van Ginkel et al. PLoS One. .

Abstract

Background: Despite ample research on depression after stroke, the debate continues regarding whether symptoms such as sleep disturbances, loss of energy, changes in appetite and diminished concentration should be considered to be consequences of stroke or general symptoms of depression. By comparing symptoms in depressed and non-depressed stroke patients with patients in general practice and patients with symptomatic atherosclerotic diseases, we aim to further clarify similarities and distinctions of depression after stroke and depression in other patient populations. Based on this, it is possible to determine if somatic symptoms should be evaluated in stroke patients in diagnosing depression after stroke.

Methods: An observational multicenter study is conducted in three hospitals and seven general practices including 382 stroke patients admitted to hospital with a clinical diagnosis of intracerebral hemorrhage or ischemic infarction, 1160 patients in general practice (PREDICT-NL), and 530 patients with symptomatic atherosclerotic diseases (SMART-Medea).

Results: The prevalence of major depressive disorder according to DSM-IV criteria was 14.1% (95% CI 11.0%-18.0%) in the stroke cohort, 5.4% (95% CI 3.8%-7.9%) in the symptomatic atherosclerotic diseases cohort and 12.9% (95% CI 11.1%-15.0%) in the general practice cohorts. Comparing depressed patients of the three cohorts demonstrated broadly similar symptom profiles, as well as comparable levels of individual symptom prevalence. However, the stroke patients suffered more severely from these symptoms than patients in the other populations.

Conclusions: The findings suggest that depression after stroke is not a different type of depression. This finding indicates that all depressive symptoms should be evaluated in stroke patients, including somatic symptoms.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Symptom profiles of stroke patients, patients with other symptomatic atherosclerotic disease and patients in general practice.
Symptoms of depression; % present at least at more than half the days. Symptoms of depression; % present on at least several days.
See this image and copyright information in PMC

References

    1. Hacket ML, Pickles K. Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. Int J Stroke 2014;9: 1017–1025. 10.1111/ijs.12357 - DOI - PubMed
    1. Robinson RG, Spalletta G. Poststroke depression: a review. Can J Psychiatry 2010;55: 341–349. - PMC - PubMed
    1. Turner-Stokes L, Hassan N. Depression after stroke: a review of the evidence base to inform the development of an integrated care pathway. Part 1: Diagnosis, frequency and impact. Clin Rehabil 2002;16: 231–247. - PubMed
    1. Ayerbe L, Ayis S, Wolfe CDA, Rudd AG. Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. Br J Psychiatry. 2013;202: 14–21. 10.1192/bjp.bp.111.107664 - DOI - PubMed
    1. Nannetti L, Paci M, Pasquini J, Lombardi B, Taiti PG. Motor and functional recovery in patients with post-stroke depression. Disabil Rehabil. 2005;27:170–175. - PubMed