Clinical Study Of Post-stroke Depression

Part one Study of the effects of psychotherapy and serotonin reuptake inhibitor to the nerve functional rehabilitation of the post-stroke depressionOBJECTIVE: To compare the efficacy of conventional therapy, psychotherapy, serotonin reuptake inhibitor and psychotherapy combined with serotonin reuptake inhibitor to the nerve functional rehabilitation in the treatment of post stroke depression.METHODS : One hundred and twenty patients with post-stroke depression were divided in to four groups randomly: control group(A), psychotherapy group(B), serotonin reuptake inhibitor group(C) and psychotherapy combined with serotonin reuptake inhibitor group(D). These groups were graded with SDS for the depression degree and MESSS for the muscle strength fore-and-aft treatment respectively. Then the statistics were analysed.RESULTS: Each anti-depression therapy has a distinct statistical difference to the improvement of depression after eight weeks in treatment of depression, And D group is more effective than others. However, each anti-depression therapy hasn't been found distinct statistical difference until twelve weeks later in treatment of muscle strength, And D group is more effective than others.CONCLUSION: Psychotherapy combined with serotonin reuptake inhibitor to the nerve functional rehabilitation in the treatment of post-stroke depression is more effective than others.Part two Post-stroke depression and its related factorsOBJECTIVE: To study the relationship of post-stroke depression (PSD) and the lesion location, cognitive function, daily activities(ADL) and neurological deficit. To explore the occurrence of early PSD and its risk factors.METHODS: To evaluate the severity of depression and the cognitive function, a questionnaire-based survey was conducted in 120 patients with stroke ,and according to the clinical examination results ,activities of daily (ADL) and degree of neurological deficit were assessed ,the incidence of PSD was also calculated. In this study, the Zung Self-Rating Depression Scale (ZSDS), Mini-Mental State Examination(MMSE), Activities of Daily Living Scale (ADLS) and assessment of delayed neurological deficit were employed to investigate the incidence of PSD in the early stage following stroke and its related risk factors in 120 cases ,for the purpose of providing clinical evidence for the prediction, treatment and prevention of PSD.RESULTS: In the 120 patients, 40(33%) were identified to have early-stage PSD. The incidence of PSD was 50%(13/26) in patients with cognitive dysfunction and 40%(34/84) in those with ADL dependence, significantly higher than the incidence of 26% in patients without cognitive dysfunction(X2=3.879,p<0.05) and that of 20% in those with total ADL independence (X2=3.7554, P<0.05).CONCLUSION: Depression is frequent in early stage after stroke, and it is markedly related with the cognitive function, ADL and degree of neurological deficits.