Long-Term Changes in Poststroke Depressive Symptoms: Effects of Functional Disability and Social Support

• Published in: The journal of neuropsychiatry and clinical neurosciences 2023, Vol.35 (3), p.244-249
• Main Authors: Ryu, Jae-Chan, Kim, Jong S
• Format: Article
• Language: English
• ISSN: 0895-0172; 1545-7222
• DOI: 10.1176/appi.neuropsych.20220134

Long-term changes in specific depressive symptoms have rarely been studied in stroke patients. Such changes and the effects of social support and functional disability on specific symptoms after a long-term follow-up period (LTP) were investigated. The Montgomery-Åsberg Depression Rating Scale (MADRS), ENRICHD Social Support Instrument, and modified Rankin Scale (mRS) for functional disability were administered at baseline, a 6-month follow-up, and an LTP (35-83 months). Effects of social support and poor functional outcome (mRS score of 3 to 6) on the 10 single items included on the MADRS were identified. Among 222 patients, mRS score, total MADRS score, and all single-item scores except "concentration difficulties," "inability to feel," and "suicidal thoughts" improved at the 6-month follow-up. From the 6-month follow-up to the LTP, the total MADRS score and half of the single-item scores worsened, although the functional outcome measure continued to improve. In multivariable linear regression tests, low social support was associated with "reduced sleep" (standardized β=0.20; 95% CI=0.06 to 0.34, p=0.005) and "pessimistic thoughts" (standardized β=0.16, 95% CI=0.03 to 0.30, p=0.019), and poor functional outcome was associated with all specific symptoms (standardized β values=0.18-0.43, all p