The Incidence Of Post-stroke Depression And The Analysis Of Related Factors

Background and ObjectiveCerebral infarction is a common and frequently-occurring disease, which causes serious damage to the human health and life. It is also one of the major causes leading middle-aged and old patients to die or disable. In recent years, the incidence of cerebral infarction has a rising trend and the patience tend to be younger. Domestic studies have found that the incidence of cerebral infarction accounted for 75% of acute cerebrovascular disease. High incidence of cerebral infarction, not only led to physical dysfunction, but also have a greater impact on the patient’s mental state, resulting in a lot of psychological problems, including depression after stroke(post-stroke depression, PSD) which is the most common. Research PSD reported prevalence varies, about 20%-70%, but more than about 40%-50%. PSD develops in the acute phase, can also occur in 1 to 2 years after cerebral infarction. If not treated, it could last more than 1 year. The clinical manifestations of mild impairment are depression, speech decrease, anxiety, sleep disorder, early awakening, losing appetite, thinking slow, energy loss, lack of confidence, etc. Severe cases manifest body unwell, psychomotor retardation and cynical suicide performance. PSD not only affected the quality of patients’ lives, but also interfere with the recovery of nerve dysfunction and increased the risk of death from cerebrovascular disease. The purpose of this study was to analyze the incidence of stroke in patients with PSD and various related factors. MethodsWe choose the patients who hospitalized in Jinan central hospital neurology hospital in October 2013 to January 2014 as the research population. According to the diagnostic criteria established on the fourth national cerebrovascular conference, the patients were all confirmed by craniocerebral CT or MRI examination. Using Hamilton Depression Scale(Hamilton Depression Rating Scale for Depression, HAMD) marked the patient. Patients who were scored smaller than eight were not depressive, scored between eight and twenty had depression symptoms, and bigger than twenty had depression. According to the set of criteria and exclusion criteria, patients were divided into PSD group, the depression group and comparable group of stroke.1. Collecting the clinical data of the tested patients. Include(1) general clinical characteristics: demographic data, tobacco and alcohol hobby(Smoking: at least 5 pieces one day, smoking more than one year in a row. History of drinking: at least 3 times per week, more than 100 ml each time, more than one year in a row. And its unit is equal to half a bottle of beer drinking, one cup of wine or a cup). Past medical history of hypertension, diabetes, hyperlipidemia, coronary heart disease, history of transient ischemic attack(TIA), and other relevant medical history.(The history of high blood pressure begins with the patient having a clinical doctor to give the diagnosis of hypertension or having already used antihypertensive drug treatment. history of diabetes for ≥ 7.0 tendency for L, fasting glucose blood glucose level any time ≥ 11.1 tendency L. Previous clinical diagnosis of diabetes or are currently taking oral glucose-lowering medications; history of coronary heart disease is always have clinical doctors to diagnosis in patients with coronary heart disease.) And using the United States National Institutes of Health Stroke Score scale(NIHSS), the modified Ran Kin scale, the Social Supported Rating Scale(SSRS) and the Medical Coping Questionnaire(MCMQ) score the tested patients.(2) The nature and stroke lesion localization: The history of cerebral infarction begin with a clinical doctor for diagnosing the patients with cerebral infarction, and should have the corresponding image such as cerebral CT or MRI results evaluation.2. Give the subjects routine craniocerebral CT or MRI examination and blood biochemistry and carotid ultrasound examination.3. Statistical Methods: Use SPSS20.0 medical statistical software for statistical analysis. Counting data used chi-square test. Measurement data used t test and Spearman correlation analysis. P <0.05 was considered to be a significant difference. ResultsIn the 51 patients, there were 38 males and 13 females. They aged from 35 to 87 years old and the average age was 67.1±10.5. There were 21 PSD patients, rating 41.16%; 9 patients with major depression, rating 17.64% and 12 patients with depression symptoms, rating 23.52%.1. Post-stroke depression and the duration of development stage have no significant correlation(P>0.05). The incidence is higher during three to six months.2. Analysis of related factors of depression after stroke.2.1 In Sociodemographic factors, age, gender and depression have found no correlation.2.2 In risk factors for cerebrovascular disease, patients with hypertension and previous history of stroke, elevated homocysteine or carotid ultrasound atherosclerosis are prone to have depression(P<0.05). While β2 microglobulin, diabetes, hyperlipidemia, and coronary heart disease, have found no correlation to depression.2.3 Looking from the occurrence of stroke lesion site, the incidence of PSD on the left lesions is higher than the bilateral lesions. Comparing the number of lesions, the incidence of PSD in multifocal patients was higher than in the patients with single lesions(P<0.05).2.4 In physical and social factors, PSD patients with severe neurological deficit(high NIHSS score), high improved Ran Kin scores and yield scores, low medical questionnaire scores and social support are correlated with depression(P<0.05). ConclusionIn patients with cerebral apoplexy, the occurrence of PSD relate to the history of high blood pressure, high homocysteine, poor social support, and nerve dysfunction caused by stroke. The left hemisphere, especially the left frontal lobe and basal ganglia lesion, multiple lesions are significantly correlated with the incidence of depression.