Post-stroke depression and antidepressant therapy effects on rehabilitation outcome

C. Marra, G. Antonucci, S. Paolucci, G. Gainotti

Research output: Contribution to journalArticlepeer-review

Abstract

The role of depression in the rehabilitation outcome of stroke patients is still controversial. In fact, different results stated either a negative effect or the absence of a role of post-stroke depression (PSD) on recovery after stroke. These controversial findings could mainly be due to the confounding effect of the antidepressant therapy. Ethical reasons prevent planning a prospective study in which one group of PSD patients is not treated. However, since in the last few years some patients with PSD were treated with antidepressants and others were not, according to the options of their physicians, we carried out a retrospective study on the effects of PSD and antidepressants on some measures of rehabilitation outcome. Sixty-four patients with recent onset (1-4 months) of monohemispheric stroke were selected among inpatients consecutively admitted from June 1994 to June 1997 to the Rehabilitation Centre 'Clinica Santa Lucia'. All the patients had been administered both a standard assessment of PSD and a standard assessment of various aspects of functional impairment. The assessment of PSD included both the Hamilton Depression Scale and the Post-Stroke Depression Rating Scale. Forty-nine patients met the DSM-IV criteria for major depression while 15 patients were classified as nondepressed. Twenty-four out of 49 PSD patients were treated with fluoxetine (20-40 mg/die). All the patients were scored according to the Barthel Index (BI), the Canadian Neurological Scale (CNS), and the Rivermead Mobility Index (RMI) at entry, after 1 month, and at the end of the rehabilitation program. No differences concerning age, sex, educational level, or side of lesion in the three groups of nondepressed, depressed and untreated, and depressed and treated stroke patients were found. In contrast, the severity of depression and the BI, CNS, RMI scores at the entry were better in nondepressed than in depressed (either treated or nontreated) group. A two-way MANOVA repeated measures showed a significant group x repeated measures interaction (Rao's R: 3.07: P

Original languageEnglish
JournalNeurological Sciences
Volume21
Issue number4 SUPPL.
Publication statusPublished - 2000

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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