J Neuropsychiatry Clin Neurosci 10:26-33, February 1998
© 1998 American Psychiatric Press, Inc.
Functional Impairment Associated With Acute Poststroke Depression
The Stroke Data Bank Study
Rajamannar Ramasubbu, M.D., F.R.C.P.C.,
Robert G. Robinson, M.D.,
Alastair J. Flint, M.B., Ch.B., F.R.C.P.C., F.R.A.N.Z.C.P.,
Todd Kosier, B.S. and
Thomas R. Price, M.D.
Received June 12, 1996; revised December 10, 1996; accepted January 13, 1997. From the Department of Psychiatry, The Queen Elizabeth Hospital and The Toronto Hospital, Toronto, Ontario, Canada; Department of Psychiatry, University of Iowa, Iowa City, Iowa; and Department of Neurology, University of Maryland Hospital, Baltimore, Maryland. Address correspondence to Dr. Ramasubbu, Speciality Program, Royal Ottawa Hospital, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada.
To examine the independent association of depression following acute stroke with impairment in activities of daily living (ADL), the authors conducted a cross-sectional analysis of stroke patients enrolled in the Stroke Data Bank (U.S.A.) who had completed the Center for Epidemiological Studies Depression Scale (CES-D). Scores on the Barthel Index, a measure of ADL, were compared between depressed (CES-D 16) and nondepressed patients (CES-D 15) at 7–10 days after stroke. Of the 626 who completed CES-D, 160 were depressed. Depressed stroke patients evidenced greater impairment in ADL than nondepressed patients, independently of all other factors that influenced poststroke physical disabilities. CES-D scores were negatively correlated with Barthel scores in the entire stroke population. Neurological factors, greater age, poor prestroke physical activity, and prestroke disturbances in sexual functioning were also independently associated with limitations in functional status of stroke patients.
Key Words: Depression • Stroke • Functional Impairment
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