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Stroke, Vol 24, 976-982, Copyright © 1993 by American Heart Association
M Astrom, R Adolfsson and K Asplund
BACKGROUND AND PURPOSE: This prospective study was designed to examine the
contributions of neurobiological, functional, and psychosocial factors to
major depression after stroke. In addition, the prevalence and longitudinal
course of major depression were studied. METHODS: Major depression,
functional ability, and social network were assessed repeatedly for a
period of 3 years in a population-based cohort of 80 patients with acute
stroke (mean age, 73 years). Cerebral atrophy and brain lesion parameters
were determined from computed tomographic scans performed acutely and after
3 years. RESULTS: The prevalence of major depression was 25% at the acute
stage and approximately the same at 3 months (31%). It decreased to 16% at
12 months, was 19% at 2 years, and increased to 29% at 3 years. The most
important predictors of immediate major depression were left anterior brain
lesion, dysphasia, and living alone. Dependence in activities of daily
living was the most important predictor at 3 months. From 12 months on, the
patient's having few social contacts outside the immediate family
contributed most to depression, and at 3 years cerebral atrophy also
contributed. At 1 year, 60% of the patients with early depression (0 to 3
months) had recovered; those not recovered at this follow-up had a high
risk of development of chronic depression. CONCLUSIONS: The study has
provided evidence of a differentiation of factors likely to be implicated
in the development of depression after stroke based or the period of time
since the stroke event.
ARTICLES
Major depression in stroke patients. A 3-year longitudinal study
Department of Psychiatry, University Hospital, Umea, Sweden.
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