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Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression

Background: Depression is the most common psychiatric condition that occurs after cerebrovascular accident, especially within the first year after stroke. Poststroke depression (PSD) may occur due to environmental factors such as functional limitations in daily activities, lower quality of life, or...

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Autores principales: Dulay, Mario F., Criswell, Amber, Hodics, Timea M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10093888/
https://www.ncbi.nlm.nih.gov/pubmed/37047944
http://dx.doi.org/10.3390/ijerph20075328
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author Dulay, Mario F.
Criswell, Amber
Hodics, Timea M.
author_facet Dulay, Mario F.
Criswell, Amber
Hodics, Timea M.
author_sort Dulay, Mario F.
collection PubMed
description Background: Depression is the most common psychiatric condition that occurs after cerebrovascular accident, especially within the first year after stroke. Poststroke depression (PSD) may occur due to environmental factors such as functional limitations in daily activities, lower quality of life, or biological factors such as damage to areas in the brain involved in emotion regulation. Although many factors are hypothesized to increase the risk of PSD, the relative contribution of these factors is not well understood. Purpose: We evaluated which cross-sectional variables were associated with increased odds of PSD in our adult outpatient stroke neuropsychology clinic population. Methods: The sample included 325 patients (49.2% female; mean age of 59-years old) evaluated at an average of 8.1 months after an ischemic or hemorrhagic stroke. Variables included in logistic regression were stroke characteristics, demographics, psychosocial factors, comorbid medical problems, comorbid psychiatric conditions, and cognitive status. The Mini International Neuropsychiatric Inventory was used to determine DSM-defined PSD and anxiety disorders. A standard neuropsychological test battery was administered. Results: PSD occurred in 30.8% of the sample. Logistic regression indicated that increased odds of PSD were associated with a comorbid anxiety disorder (5.9 times more likely to suffer from PSD, p < 0.001). Further, increased odds of PSD were associated with a history of depression treatment before stroke (3.0 times more likely to suffer from PSD), fatigue (2.8 times more likely), memory impairment (2.4 times more likely), and younger age at stroke (all p values < 0.006). Discussion: Results suggest that PSD is likely multifactorial and extends the literature by demonstrating that a comorbid anxiety disorder correlated strongest with PSD. Poststroke screening and treatment plans should address not only depression but comorbid anxiety.
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spelling pubmed-100938882023-04-13 Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression Dulay, Mario F. Criswell, Amber Hodics, Timea M. Int J Environ Res Public Health Article Background: Depression is the most common psychiatric condition that occurs after cerebrovascular accident, especially within the first year after stroke. Poststroke depression (PSD) may occur due to environmental factors such as functional limitations in daily activities, lower quality of life, or biological factors such as damage to areas in the brain involved in emotion regulation. Although many factors are hypothesized to increase the risk of PSD, the relative contribution of these factors is not well understood. Purpose: We evaluated which cross-sectional variables were associated with increased odds of PSD in our adult outpatient stroke neuropsychology clinic population. Methods: The sample included 325 patients (49.2% female; mean age of 59-years old) evaluated at an average of 8.1 months after an ischemic or hemorrhagic stroke. Variables included in logistic regression were stroke characteristics, demographics, psychosocial factors, comorbid medical problems, comorbid psychiatric conditions, and cognitive status. The Mini International Neuropsychiatric Inventory was used to determine DSM-defined PSD and anxiety disorders. A standard neuropsychological test battery was administered. Results: PSD occurred in 30.8% of the sample. Logistic regression indicated that increased odds of PSD were associated with a comorbid anxiety disorder (5.9 times more likely to suffer from PSD, p < 0.001). Further, increased odds of PSD were associated with a history of depression treatment before stroke (3.0 times more likely to suffer from PSD), fatigue (2.8 times more likely), memory impairment (2.4 times more likely), and younger age at stroke (all p values < 0.006). Discussion: Results suggest that PSD is likely multifactorial and extends the literature by demonstrating that a comorbid anxiety disorder correlated strongest with PSD. Poststroke screening and treatment plans should address not only depression but comorbid anxiety. MDPI 2023-03-30 /pmc/articles/PMC10093888/ /pubmed/37047944 http://dx.doi.org/10.3390/ijerph20075328 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Dulay, Mario F.
Criswell, Amber
Hodics, Timea M.
Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression
title Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression
title_full Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression
title_fullStr Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression
title_full_unstemmed Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression
title_short Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression
title_sort biological, psychiatric, psychosocial, and cognitive factors of poststroke depression
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10093888/
https://www.ncbi.nlm.nih.gov/pubmed/37047944
http://dx.doi.org/10.3390/ijerph20075328
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