The Study Of Clinical Heterogeneity In Post-stroke Depression

Objectives To investigate the depression heterogeneity of post-stroke depression,which is associated with the level of PSD,stroke status,past medical history,family history and other general clinical data.Methods A total of 498 patients with ischemic stroke were selected to study,who hospitalized in the Affiliated Hospital of North China University of Technology from August 2015 to December 2016.Use the Hamilton Depression Scale(HAMD)assess depression status,and selecte the 195 PSD patients(HAMD>20)as study subjects.Compare the average scores of HAMD and its subscale factors in PSD patients with different level of PSD,stroke status,past medical history,family history,and other general clinical data.Results 1 Of the 498 patients,169(36.25%)were found with PSD,154(78.97%)were mild to moderate,and 41(21.03%)were severe.2 Compared with other subscale factors,the average scores for sleep disturbance(0.69),hopelessness(0.43)and anxiety/somatizati-on(0.38)were higher,while those of diurnal variation(0.10)and weight(0.22)were lower in patients with mild to moderate PSD.For patients with severe PSD,compared with other subscale factors,the average scores for sleep disturbance(0.80),weight(0.59)and anxiety/somatization(0.58)were higher,but those of diurnal variation(0.13)and cognitive disturbance(0.38)were lower.3 The HAMD total score and average scores of anxiety/somatization in women were higher than men of PSD patients,the difference was statistical significant(P<0.05).But the average scores of hopelessness in women were lower than men of PSD patients,the difference was statistical significant(P<0.05).4 The HAMD total score and average scores of anxiety/somatization,cognitive disturbance,sleep disturbance in the older were higher than the young and middle-aged of PSD patients,the difference was statistical significant(P<0.05).But the average scores of retardation and hopelessness in the older were lower than the young and middle-aged of PSD patients,the difference was statistical significant(P<0.05).5 The HAMD total score and average scores of anxiety/somatization in PSD patients with coronary heart disease were higher than the patients with not,the difference was statistical significant(P<0.05).6 The HAMD total score and average scores of weight,retardation,sleep disturbance in PSD patients with positive family history of mental illness were higher than the patients with negative family history,the difference was statistical significant(P<0.05).7 The HAMD total score and average scores of anxiety/somatization,sleep disturbance in PSD patients with multiple strokes were higher than the patients with first stroke,the difference was statistical significant(P<0.05).The HAMD total score in PSD patients with other lesions were lower than the patients with single frontal lobe lesion and basal ganglia lesions,the difference was statistical significant(P<0.05).The HAMD average scores of anxiety/somatization in PSD patients with single frontal lobe lesion were higher than the patients with single temporal lobe,basal ganglia and other lesions,the difference was statistical significant(P<0.05).The HAMD average scores of retardation in PSD patients with single basal ganglia lesion were higher than the patients with single frontal lobe and other lesions,the difference was statistical significant(P<0.05).8 The HAMD total score and average scores of anxiety/somatization,weight,retardation in PSD patients with the lower score group of ADL were higher than the higher score group,the difference was statistical significant(P<0.05).The HAMD total score and average scores of anxiety/somatization,weight,retardation,sleep disturbance in PSD patients with the higher score group of NIHSS were higher than the lower score group,the difference was statistical significant(P<0.05).9 The HAMD total score and average scores of cognitive disturbance,retardation,sleep disturbance in PSD patients with the higher level group of Hcy were higher than the lower level group,the difference was statistical significant(P<0.05).The HAMD total score in PSD patients with the higher level group of TC were higher than the lower level group,the difference was statistical significant(P<0.05).Conclusions 1 There was probably clinical heterogeneity in patients with PSD,which is associated with the level of PSD,stroke status,past medical history,family history,and other general clinical data.2 Should develope personalized treatment regimen and use rational medicines to improve the effects and prognosis.