Stroke, Vol 18, 837-843, Copyright © 1987 by American Heart Association
RG Robinson, PL Bolduc and TR Price
As part of a prospective study of mood disorders in stroke patients,
interviews were obtained from 37 patients at 1 year and 48 patients at 2
years follow-up. In-hospital evaluations for these 65 follow-up patients
found that 9 patients (14%) had symptom clusters of major depression, 12
patients (18%) had symptom clusters of dysthymic or minor depression, and
44 patients (68%) did not meet the DSM III diagnostic criteria for
depression. Although overall prevalence of depression did not change
significantly over time, the prognosis for individual patients, depending
on diagnostic group, was different. All of the follow-up patients with
major depression in-hospital were improved by 2 years, with a significant
reduction in their mean depression scores and improvement in their
activities of daily living, whereas only 30% of follow-up patients with
dysthymic depression improved by this time. There was no significant
improvement in their mean depression scores or mean activities of daily
living score. Of the patients followed up who were not depressed
in-hospital, 34% had developed major or minor depression by 2 years, and
their mean depression scores were significantly increased. These data
suggest that the prevalence of depression among the follow-up patients
remains high (between 30 and 40%) for the first 2 years after stroke, but
that untreated poststroke major depression has a natural course of about
1-2 years, with associated improvement in activity of daily living scores,
whereas the prognosis for poststroke dysthymic depression is frequently
unfavorable and often persists for greater than 2 years.
ARTICLES
Two-year longitudinal study of poststroke mood disorders: diagnosis and outcome at one and two years
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