Depression predicts unfavourable functional outcome and higher mortality in stroke patients: The Bergen Stroke Study

Næss, Halvor; Lunde, Linn-Heidi; Brøgger, Jan; Waje‐Andreassen, Ulrike

doi:10.1111/j.1600-0404.2010.01373.x

Cited by 43 publications

(36 citation statements)

References 10 publications

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“…The Bergen Stroke Study investigators sought to explore the relationship between pre-stroke depression and disability after stroke and demonstrated that pre-stroke depression is associated with increased 6-month disability as measured by the Barthel Index and modified Rankin scale (6). The effect of depression and depressive symptoms on outcome could be mediated by a number of factors.…”

Section: Discussionmentioning

confidence: 99%

“…The effect of depression and depressive symptoms on outcome could be mediated by a number of factors. Pre-stroke depression predicts development of post-stroke depression which is related to stroke outcome (6). Depressive symptoms may impact behaviors such as willingness to participate in rehabilitation, thereby limiting improvements in function.…”

Section: Discussionmentioning

confidence: 99%

“…Depression is associated with stroke incidence (3, 11) and mortality (3, 5, 6) as well as with stroke recovery and cognitive status (5–7). Several studies support the hypothesis that social support has an impact on stroke outcome (12–15).…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Pre-Stroke Depressive Symptoms, Fatalism, and Social Support on Disability after Stroke

Sharrief

Sánchez

Lisabeth

et al. 2017

Journal of Stroke and Cerebrovascular Diseases

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Background Psychological and social factors have been linked to stroke mortality; however, their impact on stroke disability is unclear. The purpose of this study was to evaluate the impact of pre-stroke fatalism, depressive symptoms, and social support on 90-day neurological, functional, and cognitive outcomes. Methods Ischemic strokes (2008–2011) were identified from the Brain Attack Surveillance in Corpus Christi Project. Validated scales were used to assess fatalism, depressive symptoms, and social support during baseline interviews. The National Institutes of Health Stroke Scale (NIHSS), Activities of Daily Living/ Instrumental Activities of Daily Living (ADL/IADL) scale, and Modified Mini-Mental State Exam (3MSE) were used to assess 90-day outcomes. The associations between the pre-stroke variables and 90-day outcomes were estimated from regression models adjusting for demographics, risk factors, tPA treatment, and comorbidities. Results Among 364 stroke survivors, higher pre-stroke fatalism was associated with worse functional (0.17 point higher ADL/IADL per IQR higher fatalism; CI 0.05, 0.30) and cognitive (2.81 point lower 3MSE per IQR higher fatalism; CI 0.95, 4.67) outcomes. Higher pre-stroke depressive symptoms were associated with worse functional (0.16 point higher ADL/IADL per IQR higher PHQ-9; CI 0.04, 0.28) and cognitive (2.28 point lower 3MSE per IQR higher PHQ-9; CI 0.46, 4.10) outcomes. Participants in the middle tertile of social support had better cognitive outcomes (3.75 points higher 3MSE; CI 0.93, 6.56) compared to the highest tertile. Conclusions The associations between pre-stroke fatalism, depressive symptoms, and social support and 90-day outcomes suggest that psychosocial factors play an important role in stroke recovery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Impact of Pre-Stroke Depressive Symptoms, Fatalism, and Social Support on Disability after Stroke

Sharrief

Sánchez

Lisabeth

et al. 2017

Journal of Stroke and Cerebrovascular Diseases

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“…diet and exercise) to prevent recurrence, and assertiveness in seeking acute medical care. Depression may influence the association of these psychological factors with stroke outcome as depression is clearly associated with stroke outcome 5 and is also associated with these psychological factors 6, 7, 8 . Depression has also been linked to vascular disease pathophysiology 9 .…”

Section: Introductionmentioning

confidence: 99%

Fatalism, Optimism, Spirituality, Depressive Symptoms, and Stroke Outcome

Morgenstern

Sánchez

Skolarus

et al. 2011

Stroke

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Background and Purpose We sought to describe the association of spirituality, optimism, fatalism and depressive symptoms with initial stroke severity, stroke recurrence and post-stroke mortality. Methods Stroke cases June 2004–December 2008 were ascertained in Nueces County, Texas. Patients without aphasia were queried on their recall of depressive symptoms, fatalism, optimism, and non-organizational spirituality before stroke using validated scales. The association between scales and stroke outcomes was studied using multiple linear regression with log-transformed NIHSS and Cox proportional hazards regression for recurrence and mortality. Results 669 patients participated, 48.7% were women. In fully adjusted models, an increase in fatalism from the first to third quartile was associated with all-cause mortality (HR=1.41, 95%CI: 1.06, 1.88), marginally associated with risk of recurrence (HR=1.35, 95%CI: 0.97, 1.88), but not stroke severity. Similarly, an increase in depressive symptoms was associated with increased mortality (HR=1.32, 95%CI: 1.02, 1.72), marginally associated with stroke recurrence (HR=1.22, CI: 0.93, 1.62), and with a 9.0% increase in stroke severity (95%CI: 0.01, 18.0). Depressive symptoms altered the fatalism-mortality association such that the association of fatalism and mortality was more pronounced for patients reporting no depressive symptoms. Neither spirituality nor optimism conferred a significant effect on stroke severity, recurrence or mortality. Conclusions Among patients who have already had a stroke, self-described pre-stroke depressive symptoms and fatalism, but not optimism or spirituality, are associated with increased risk of stroke recurrence and mortality. Unconventional risk factors may explain some of the variability in stroke outcomes observed in populations, and may be novel targets for intervention.

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“…[6] Only a few studies consider overall impact of the factor on the prognosis of patients. However, due to low viscosity of rehabilitation patients, the samples of existing studies generally in a single hospital, a single area, it is difficult to follow the actual follow-up of patients with hospital conditions caused by the results of bias.…”

Section: Introductionmentioning

confidence: 99%

Predicting rehabilitation treatment helpfulness to stroke patients: A supervised learning approach

Tseng

2017

AIR

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Stroke (Cerebral vascular accident, CVA) is a common and serious disease. Most of the survivals would be disabled after their illness recovery, causes serious burden on caregivers. It is said that rehabilitation could help functional recovery of stroke patients, regain independence after stroke. Due to the long course of stroke, how to prevent survivals from recurrence is an important issue. This study attempts to examine the relationship between stroke recurrence and strength of rehabilitation, and build a stroke recurrence prediction model utilizing a number of supervised learning techniques to assist physicians with making clinical decisions.In the past, most of the related work used the samples from a single hospital as a sample, but it cannot fully catch all the clinic information of the patients. Therefore, this study used the Longitudinal Health Insurance Database 2010 of the NHIRD as the data source, to examine the effectiveness of rehabilitation.In terms of accuracy rate of all classifiers, we get the best effectiveness (78%) while adopting the inpatient admission dataset and C4.5 to predict recurrence. We also find physical therapy, occupational therapy and speech therapy treatments during inpatient admission are the key factors to decrease the chance to recrudesce in the rehabilitation periods. The higher strength and frequency rehabilitation treatment is also the key influence variables in our high accuracy prediction model which means that is useful to lower the recurrence rate of stroke patients.

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Depression predicts unfavourable functional outcome and higher mortality in stroke patients: The Bergen Stroke Study

Abstract: This study has identified several factors associated with PSD. PD predicts more severe stroke on admittance and less functional improvement both in the short- and the long-term. Both PD and PSD predict higher long-term mortality.

Cited by 43 publications

References 10 publications

The Impact of Pre-Stroke Depressive Symptoms, Fatalism, and Social Support on Disability after Stroke

The Impact of Pre-Stroke Depressive Symptoms, Fatalism, and Social Support on Disability after Stroke

Fatalism, Optimism, Spirituality, Depressive Symptoms, and Stroke Outcome

Predicting rehabilitation treatment helpfulness to stroke patients: A supervised learning approach

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