Abstract

The Complexity of the Factors Increasing the Depressive Symptoms among Patients in the Acute Phase after Stroke

Author(s): Liberacka Donata, Bober-Płonka Bogusława, Ćwięk Aleksandra, Bartyzel Gabrielala, Przewłocki Ryszard, Nowak Ryszard, Słotwińska Katarzyna

ABSTRACT
Background
Depression is the most prevalent neuropsychiatric disorder among post-stroke patients.Depressive symptoms can be observed already in the first few days following the stroke onset.The aim of this research was to identify specific factors or groups of factors that contribute to
the occurrence of depressive symptoms among patients in the acute phase after ischemic stroke.

Methods and findings
The experimental group consisted of 95 patients after ischemic stroke. The inclusion criteria were strictly specified diagnostic criteria encompassing neuroimaging procedures CT and MRI, physical and neurological examination.The experimental procedure involved neuropsychological cognitive assessment (MMSE, The Clock Drawing Test, selected experimental methods from the ÃÃÃÃ�?�?Â�?�?ÂÃ�?�?Â�?�?ÂÃÃ�?�?Â�?�?ÂÃ�?�?Â�?�?ÂÃÃÃ�?�?Â�?�?ÂÃ�?�?Â�?�?ÂÃÃ�?�?Â�?�?ÂÃ�?�?Â�?ucki Book), observations, and questionnaires for mood disorders (BDI, HDRS). Depressive symptoms were observed among 57%-69% of the patients in the acute phase after ischemic stroke (dependent on the measure applied). Generalized Regression Model (GRM) was applied to explore relationship between measured variables and the severity of depressive symptoms. A correlation was observed between depressive symptoms measured with HDRS and general cognitive functioning measured with MMSE. Additionally, two other factor groups: 1) gender, consciousness level at the onset, hemisphere damage side, and 2) gender, marital status, hemisphere damage side, were found to be significantly correlated with the severity of depression in the acute phase after
stroke. The specific correlations between these variables are described in this article. However, the analysis did not confirm for instance a simple correlation between depression and the hemispheric localization of stroke.

Conclusion
General, organic and functional risk factors for post-stroke depression do not have an isolated influence on the emotional state of the patients. These factors, from the beginning, are influencing each other. It is therefore necessary to consider the possibility of their complex interactions in the occurrence of post-stroke depressive symptoms from the early stages of diagnosis and rehabilitation