The Studies On Relationship Between Post-stroke Depression And Its Related Factors

Objective: To explore the incidence of the post-stroke depression and its related factors . To study the relationship between the post-stroke depression and the cognitive impairment and the neurological deficits.Methods:106 patients of acute stroke hospitalized in Xinhua Hospital attached to Dalian University from January 2005 to February 2007. the diagnosis of Acute stroke was made according to the criteria established in the National Fourth Session of cerebrovascular disease academic conference in 1995. The clinical characteristics were performed an average of 2 weeks after the onset of stroke using a standardized questionnaire. Post stroke depression (PSD) was considered to be present when either the Hamilton Depression Scale (HAMD) score or the ICD-10 F06.32 criteria were met. The neurological deficit by the Scandinavian Stroke Scale (SSS) were assessed. The degree of cognitive impairment was evaluated with Mini-Mental State Examination(MMSE). Then analyzed the correlativity of the patient's HAMD with SSS and MMSE, the relation of PSD with the location, the nature of the post-stroke, the numbers of lesion and the left or right hemisphere lesion. Also analyzed the relation between the patients'age, gender, marital situation , years of schooling , occupation and the incidence of PSD . The difference between the patient's incidence of the PSD was compared with the vascular risk factors such as hypertension, diabetes, coronary artery disease , smoking and drinking with that in the non-depressive group . Logistic regression analysis was performed on the important related factors of post-stroke depression including age , sex, hypertension, diabetes, drinking ,cognitive dysfunction and neurological deficits .Results:1.The incidence of post-stroke depression is about 48.11%, including mild patients24(47.06%), moderate patents 20(39.22%) and severe patents 7 (13.73). Mild and moderate PSD are more common.2.The incidence of PSD was in female than male (P<0.01).3.The incidence of the PSD in the middle age group (40-60 age)was higher than the aged group(≥60 age)(P<0.01).4.Regarding the marital and the occupation situation, there were no significant difference(P>0.05), but the more educated the patients are, the higher incidence of the PSD.5. The incidence of PSD is not related with the nature of the acute stroke (p>0.05).6. The lesion location in the left hemisphere of the brain has a higher morbidity than that in the both sides or right hemisphere. There was a significant difference in the incidence of the PSD between the several lesion location and the single lesion location(P<0.01).7. The patients with hypertension , diabetes and drinking in the depressive group in the incidence of the PSD were significantly higher than that in the non-depressive group . There was a significant difference in the incidence of the PSD between the patients with the vascular risk factors and without the vascular risk factor(P<0.01).8.The total score of MMSE in the depressive group was23.24±2.605 , significantly lower than that in the non-depressive group (25.49±3.711),and the total score of SSS in the former group was22.25±7.451 , significantly higher than that in the latter one (14.33±7.301) (P=0.000) .The total score and factor scores of HAMD were negatively related to the total score of MMSE (r=-0.332～-0.010) and positively related to the total scores of SSS in all patients (r=0.202～0.829). Post-stroke depression is associated with cognitive impairment and serious degree of neurological deficits.9 . Logistic regression analysis showed that related factors of post-stroke depression included age , sex, years of schooling, the location of lesion, hypertension, diabetes, drinking, cognitive dysfunction, and neurological deficits. Age, sex, hypertension, cognitive dysfunction and neurological deficits are more correlative elements .Conclusions1. Post-stroke depression with many more related factors such as the patient'age, sex and education level is a common complication after stroke. Most PSD patents are mild and moderate.2. The lesion location in left hemisphere of the brain has a higher morbidity than that in the both or right hemisphere. The incidence of the PSD with several lesion locations is higher than that of the single lesion location(P<0.01).3. The vascular risk factors like hypertension , diabetes and drinking are the more correlative elements with the morbidity of post-stroke depression.4. PSD patients have severe neurological deficits and cognitive impairments. The degree of the neurological deficits and cognitive impairments showed a significant relationship with the degree of PSD.