Correlates of depressive symptoms in individuals attending outpatient stroke clinics

Abstract

<p><b>Background and purpose</b> Depressive symptoms are common post-stroke. We examined stroke deficits and lifestyle factors that are independent predictors for depressive symptomology. <b>Methods</b> A retrospective chart review was performed for patients’ post-stroke who attended outpatient clinics at a hospital in Southwestern Ontario between 1 January 2014 and 30 September 2014. Demographic variables, stroke deficits, secondary stroke risk factors and disability study measures [Patient Health Questionnaire-9 (PHQ-9) and Montreal Cognitive Assessment (MoCA)] were analyzed. <b>Results</b> Of the 221 outpatients who attended the stroke clinics (53% male; mean age = 65.2 ± 14.9 years; mean time post-stroke 14.6 ± 20.1 months), 202 patients were used in the final analysis. About 36% of patients (mean = 5.17 ± 5.96) reported mild to severe depressive symptoms (PHQ-9 ≥ 5). Cognitive impairment (CI), smoking, pain and therapy enrollment (<i>p</i> < 0.01) were significantly associated with depressive symptoms. Patients reporting CI were 4 times more likely to score highly on the PHQ-9 than those who did not report CI (OR = 4.72). While controlling for age, MoCA scores negatively related to depressive symptoms with higher PHQ-9 scores associated with lower MoCA scores (<i>r</i>= −0.39, <i>p</i> < 0.005). <b>Conclusions</b> High levels of depressive symptoms are common in the chronic phase post-stroke and were partially related to cognition, pain, therapy enrollment and lifestyle factors.Implications for Rehabilitation</p><p>Stroke patients who report cognitive deficits, pain, tobacco use or being enrolled in therapy may experience increased depressive symptoms.</p><p>A holistic perspective of disease and lifestyle factors should be considered while assessing risk of depressive symptoms in stroke patients.</p><p>Patients at risk for depressive symptoms should be monitored at subsequent outpatient visits.</p><p></p> <p>Stroke patients who report cognitive deficits, pain, tobacco use or being enrolled in therapy may experience increased depressive symptoms.</p> <p>A holistic perspective of disease and lifestyle factors should be considered while assessing risk of depressive symptoms in stroke patients.</p> <p>Patients at risk for depressive symptoms should be monitored at subsequent outpatient visits.</p