Characteristics And Related Factors Of Poststroke Depression In Acute Stage

Objective:To observe the characteristics and related factors of poststroke depression in acute stage.Methods:According to the inclusion criteria and exclusion criteria,140 cases of acute cerebral stroke patients hospitalized in the Department of Neurology of our hospital from January 2014 to June 2014 were recruited. Two weeks after the onset of stroke, the 17-version Hamilton Depression Rating scale (HAMD) was used, In combination HAMD scale score with CCMD-3 diagnostic criteria for depression, patients were divided into PSD group and without-PSD group, and the PSD group were divided further into mild and moderate-severe depression group. Then we calculated the incidence of PSD. The relationship between PSD and sociology factors (including age, gender, family income, etc), Risk factors of cerebrovascular disease (including hypertension, diabetes, dyslipidemia, heart disease, etc), clinical factors (including NIHSS score, recurrence or progress of stroke, pulmonary infection, etc), lesion location (including side and anatomic sites), stroke type, blood risk factors for stroke (including high-sensitivity C reactive protein, homocysteine, floate, Vitamin-B12, etc) were analyzed. Some risk factors were also analyzed according to age and gender stratification.Results:1. The overall incidence of PSD was 34.8%. mild depression accounted for 27.7%and moderate-severe depression accounted for 7.1%. The incidence for male, femal, age＜60 and age≥60 patients were 38.7%,27.7%,25.0%,45.6% respectively.2. Analysis of relationship between PSD and related factors.2.1 Between without-PSD and PSD, among different levels in depression groups, age showed significant difference, and elderly patients were at higher risk of PSD compared to young patients. The study found sex, family income, educational level, job, marriage and residence did not had significant differences.2.2 Risk factors of cerebrovascular disease had no significant correlation with PSD in stroke patients and in patients with different gender, but the presence of cerebrovascular stenosis was a risk factor of PSD for patients with age≥60.2.3 Between without-PSD and PSD, among different levels in depression groups, NIHSS score, pulmonary infection showed significant differences. High NIHSS score and pulmonary infection were risk factors of PSD. Moreover, NIHSS score was significantly correlated with the severity of PSD.2.4 The right parietal lobe lesion was a risk factor of PSD. Lesion located in the right temporal lobe was correlated with moderate-severe PSD. In addition,cerebal hemorrhage was a risk factor of PSD for patients with age<60. Right basal ganglia lesion was a risk factor for patients with age≥60.2.5 High level of fasting blood glucose was associated with moserate-severe PSD. Elevated glycosylated hemoglobin was a risk factor of moderate-severe PSD for patients with age≥60.2.6 Age and NIHSS score were independent risk factors of PSD in acute stage. Conclusion:1. The overall incidence of PSD was 34.8%in two weeks after the onset of stroke, with mild depression the most common type. It was higher in male and elderly patients.2. High age, high NIHSS score, pulmonary infection and the right parietal lobe lesion were siginificantly associated with the occurrence of PSD two weeks after the onset of stroke. Futhermore, the right temporal lobe lesion and high level of fasting blood glucose were risk factors of moderate-severe PSD. Age and NIHSS score were independent risk factors of PSD. In addition, cerebrovascular stenosis and lesion located in the right basal ganglia were risk factors of PSD for patients with age≥60, whereas, cerebral hemorrhage was a risk factor for patients with age＜60.