| Background: Although depression is common after stroke, there is uncertainty over its etiology and risk factors. Depression negatively interferes with rehabilitation outcome and increases mortality and morbidity. Knowledge of the predictors of depression associated with stroke may allow for the better targeting of therapy, both prevention and treatment.Purpose: Our objectives were to determine the high prevalence of post stroke depression in stroke acute phase and to establish the best predictors. We expected to improve the clinician's attention and to provide clinical evidence for early diagnosis and treatment for post stroke depression.Methods:A prospective study carried out among selected acute stroke survivors in our hospital. The patients were from the Neurology Department of Guangxi medical university first affiliated hospital during January 2010 to December 2010. Subjects included those who satisfied the WHO definition of stroke. The necessary conventional data was obtained from each subject; including socio-demographic, medical history, blood biochemical and Transcranial Doppler (TCD), Computed Tomography (CT) or Magnetic resonance imaging (MRI) scan examination. Depressive symptoms were assessed in 2 ~ 4 weeks after the onset of stroke and a series of scales were administered. PSD was diagnosed as depression through the diagnostic criteria of depression in CCMD-3 of Chinese and the Hamilton Depression Rating Scale and the others were control group. The Hamilton Anxiety Rating Scale was performed to evaluate the anxiety status. The neurological deficit was estimated by Clinical Neurological Defect Scale. The degree of cognitive impairment was evaluated with Mini-Mental State Examination (MMSE). The daily life skills were assessed by Activities of Daily Living Scales (ADL). The quantitative data was analyzed by two-sample test or Mann - Whitney U rank sum test and the qualitative data was analyzed by chi-square test with SPSS13.0 statistical software. The binary classification unconditional Logistic regression analysis was performed on the important related factors of PSD.Results:1. A total of 224 stroke survivors were studied, 78 cases were conform to the standard. The incidence of PSD is 34.8%,including mild patients56(71.8%), moderate patients13(16.7%) and severe patients9(11.5%). Mild PSD makes the majority.2. We found no statistically significant difference in sex, average age, income and marital status, hypertension, diabetes, smoking, alcohol consumption, lipid level and fibrinogen (FIB) between the case group and the control group. Manual workers, low culture level and living in rural areas were preferred to suffering from PSD (p<0.01).3. Form the characteristics of stroke, we found that the incident of PSD were not related with the nature of stroke, the amount of lesion location, the basal ganglia, seahorses, parietal lobe and occipital lobe stroke(p>0.05). Multiple stroke , large areas lesion, the left hemisphere stroke, thalamus, Temporal lobe, Frontal lobe lesion were likely to be developed into PSD (p<0.05).4. The total score of MMSE and ADL in the depression group was significantly lower than that in the non-depression group. The score of HDMD and HAMA and CNDS in the case group was significantly higher than in the control group. PSD is associated with cognitive, anxiety and serious degree of neurological deficits.5. Logistic regression analysis showed that living in rural areas, multiple stroke, large areas lesion, the left hemisphere stroke, Temporal lobe, Frontal lobe lesion were consistently associated with depression and the scores of ADL and MMSE is protection factors of PSD.Conclusions:1. Post stroke depression is frequent after stroke with many more related factors. Living in rural areas and multiple stroke and lesion location in left hemisphere of the brain and larger and frontal lobe lesion were preferred to suffering from PSD.2. PSD patients have severed cognitive impairments and neurological deficits.3. Therapy with PSD is so severe that clinicians should strengthen for the attention.
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