Objectives: To identify the prevalence of poststroke depression (PSD) in a
population of patients admitted for rehabilitation of neurologic sequelae o
f their first stroke, to recognize reliable prognostic factors associated w
ith the occurrence of PSD, and to evaluate the impact of PSD on the results
of rehabilitation treatment.
Methods: In a prospective study of 470 of 508 consecutive patients admitted
to a rehabilitation hospital for sequelae of their first stroke, the relat
ion between 23 independent variables and the development of depression was
assessed by using a logistic regression analysis (forward stepwise). In add
ition, the impact of PSD on basal disability and on rehabilitation results
was assessed by multiple measures (length of stay, efficiency, effectivenes
s, and percent of low responders on activities of daily living [ADL] and mo
bility).
Results: PSD occurred in 129 patients (27.4%). Being female and having more
than 8 years of schooling were associated with a higher probability of dev
eloping depression (odds ratio [OR] = 1.94, 95% confidence interval [CI] =
1.27-2.96, and OR = 1.61, 95% CI = 1.04-2.48, respectively). No association
was found with site or side of cerebral lesion. In a logistic model, depre
ssion was a significant independent predictor (OR = 1.99, 95% CI = 1.14-3.4
6) of low response on ADL in spite of treatment.
Conclusions: PSD occurs especially in female patients and in patients with
a high level of education and, even if treated, may affect rehabilitation r
esults, No association was found between brain lesion location and PSD. (C)
1999 by the American Congress of Rehabilitation Medicine and the American
Academy of Physical Medicine and Rehabilitation.