Socioeconomic Factors Predicting Depression Differ in the Acute Stage and at 1 year After Ischemic Stroke or TIA

Abstract

Introduction: Considerable depressive symptoms follow stroke in about one third of patients. Initial depressive symptoms may wane after the acute phase of stroke, but persisting depressive symptoms adversely affect rehabilitation and quality of life. We set forth to evaluate predictors of depressive symptoms with a focus on socioeconomic factors. Methods: We evaluated clinical features and socioeconomic characteristics in 233 consecutive patients with acute ischemic stroke or TIA. Depressive symptoms could be evaluated in 168 subjects in the acute phase with a repeated testing after a mean of 14.7 months via telephone interview in 116 patients. Survival status, scores on the Center for Epidemiologic Studies-Depression Scale (CES-D), Beck Depression Inventory (BDI) and disability (modified Rankin scale, mRS) were recorded. Results: In the acute phase, employment status (p = 0.037) and level of education (p = 0.048) whereas one year later dependency (mRS3, p = 0.002) and income (p = 0.012) were the significant predictors of the severity of depressive symptoms. A change from independent (mRS2) to dependent living predicted worsening depressive symptoms (p = 0.008), whereas improving to functional independence from an initially dependent condition was associated with diminishing depressive symptoms (p = 0.077 for CES-D and p = 0.044 for BDI) in the first year after an acute ischemic cerebrovascular event. Conclusions: Predictors of the severity of depressive symptoms differed in the acute phase and at follow-up. In addition to disability, education and employment status in the acute phase and income in the late phase predict the severity of depressive symptoms after ischemic stroke or TIA.

Influence of Physical Activity and Socio-Economic Status on Depression and Anxiety Symptoms in Patients after Stroke

“…Based on the research carried out in this study, it can be concluded that health state and physical fitness do not affect the severity of the present clinical picture for hemiparesis caused by ischemic stroke, while patients who assess them better, show greater improvement during treatment. However, it is noted that the deterioration of socio-economic conditions, health, and physical fitness is a significant risk factor for depression [12,13,37].…”

“…Indicators of social isolation, poor material, and social situation, and positive medical history in terms of family burden of affective diseases can be treated as relatively wellsubstantiated. Since it is believed that lonesome patients living in poor housing conditions show a higher level of depression and more often stop receiving medical services and rehabilitation treatments [12,13].…”