Depression improvement is related to social role functioning after stroke

Arch Phys Med Rehabil. 2012 Jun;93(6):978-82. doi: 10.1016/j.apmr.2011.12.012. Epub 2012 Mar 20.

Abstract

Objectives: To (1) examine the relationships between baseline demographic, clinical, and psychological characteristics and social role functioning (SRF) at 4 months after stroke, and (2) assess whether depression improvement is associated with 4-month SRF.

Design: We completed a secondary data analysis using data from a completed cohort study including people with stroke with or without depression. We used multiple linear regression to identify variables independently associated with 12-week SRF.

Setting: Hospital and patients' homes. The intervention was via phone calls.

Participants: People with a new stroke recruited during the inpatient stay (N=371, depressed only n=176). All survived an ischemic stroke, were 18 years and older, spoke and understood English, owned a telephone, had no severe language or cognitive impairments, and were expected to live at least 6 months.

Interventions: Not applicable.

Main outcome measures: We measured depression with the Patient Health Questionnaire-9 (PHQ-9), and depression improvement was defined by a 50% decrease in PHQ-9 scores from baseline to 12 weeks or a 12-week PHQ-9 score <10. SRF was measured with the social domain of the Stroke-Specific Quality of Life Scale.

Results: Depression and comorbidities were found to be independently associated with 12-week SRF. Importantly, depression response (or depression improvement) was the only variable to independently predict SRF in the depressed-only group.

Conclusions: Among stroke survivors with depression, improvement of that depression was independently associated with improved SRF. This is a reminder of the importance for rehabilitation providers to screen for and treat poststroke depression.

Publication types

  • Comparative Study

MeSH terms

  • Activities of Daily Living*
  • Age Distribution
  • Aged
  • Databases, Factual
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / etiology
  • Depressive Disorder / physiopathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Interpersonal Relations
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neuropsychological Tests
  • Physical Therapy Modalities
  • Quality of Life*
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution
  • Sickness Impact Profile
  • Social Adjustment*
  • Stroke / complications
  • Stroke / psychology*
  • Stroke Rehabilitation
  • Surveys and Questionnaires
  • Survivors
  • Treatment Outcome