The dynamics of Poststroke depression among Ghanaians

JOURNAL OF THE NEUROLOGICAL SCIENCES

卷:405

Article

Sarfo, Fred Stephen^1,2  Agbenorku, Manolo²  Adamu, Sheila²  Obese, Vida²  Berchie, Patrick²  Ovbiagele, Bruce³ 

[1] Kwame Nkrumah Univ Sci & Technol, Dept Med, Kumasi, Ghana

[2] Komfo Anokye Teaching Hosp, Dept Med, Kumasi, Ghana

[3] Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA

关键词: Post-stroke depression;    Ghana;    Risk factors;    Stroke severity;    Fluoxetine;   

DOI  :  10.1016/j.jns.2019.07.028

来源: Elsevier

【 摘 要 】

Objective: The very few published data on post-stroke depression (PSD) among indigenous Africans have covered its prevalence and predictors. We sought to evaluate the dynamics of PSD in a cohort of Ghanaian stroke survivors followed for 9 months after an acute stroke. Methods: Stroke survivors in this prospective cohort were adults aged > 18 years with CT scan confirmed stroke, recruited into a randomized controlled trial to assess the feasibility of an mHealth technology-enabled, nurse guided intervention for blood pressure control. PSD was assessed a secondary outcome measure using the Hamilton Depression Rating Scale (HDRS) at enrollment, months 3, 6, and 9. Those with a score of > 7 points on HDRS were categorized as depressed. A multivariate logistic regression analysis was performed to identify independent predictors of PSF. Results: Mean age of study participants was 55.1 +/- 12.7 years with 65% being males. Ischemic strokes comprised 76.6% of study population. Prevalence of PSD at baseline was 78.6%, 43.6% at month 3, 41.1% at month 6 and 18.2% at month 9 (p < .0001). Factors significantly associated with PSD at baseline were higher NIH Stoke Scale score (adjusted OR 1.51, 95% CI: 1.03-2.23) and pain (adjusted OR 7.18, 95% CI: 1.52-33.89). NIHSS score (adjusted OR, 1.99, 95% CI: 1.12-3.52) as associated with PSD at month 9. Conclusion: 80% Ghanaian stroke survivors have early PSD declining to 20% at month 9. Stroke severity is the persistent factor associated with PSD at baseline and follow-up, and good be a target for screening and promptly treating PSD.

【 授权许可】

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