ADVERTISEMENT
Post-Stroke Depression Predicted by Depression History, Higher Inpatient PHQ-9 Score
A history of depression and a Patient Health Questionnaire-9 (PHQ-9) score of 5 or higher are significant predictors of depression among inpatients with stroke, according to study results published online in BMC Psychiatry.
“These results suggest that individuals with a history of depression and those reporting depressive symptoms during hospitalization deserve additional consideration for targeted treatment with antidepressants,” wrote corresponding author Elisabeth Breese Marsh, MD, and coauthors from the Johns Hopkins University School of Medicine Department of Neurology, Baltimore, Maryland.
The retrospective analysis included 307 patients with acute ischemic stroke treated at an urban academic comprehensive stroke center between October 2016 and December 2020. During an outpatient visit 4 to 6 weeks after discharge, patients were administered the Patient Health Questionnaire-9 to assess for post-stroke depression.
>>News: Intensive Blood Pressure Control After Stroke Harms More Than Helps
Just over half (54.4%) of patients had post-stroke depression at the 4- to 6-week follow-up, according to the study. Odds ratios for post-stroke depression were 4.11 with a history of depression and 1.17 with a higher inpatient PHQ-9 score. On the other hand, stroke severity, marital status, living alone, employment, and outpatient therapy were not associated with post-stroke depression.
Among patients with an inpatient PHQ-9 score of 5 or higher, those who initiated selective serotonin reuptake inhibitors (SSRI) after their stroke showed a 4.12 point improvement at follow-up compared with patients without post-stroke SSRIs, researchers reported. No similar trend was seen in patients with PHQ-9 scores below 5.
“Stratifying by severity of depressive symptoms in the inpatient setting and selectively initiating SSRIs among patients with higher PHQ-9 scores may help reduce the burden of stroke recovery while minimizing risk of adverse side effects,” researchers advised.
Reference
