Indian Journal of PsychiatryIndian Journal of Psychiatry
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ORIGINAL ARTICLE
Year : 2019  |  Volume : 61  |  Issue : 6  |  Page : 605-611

Characteristics and correlates of poststroke depression: An Indian study


1 Department of Psychiatry, KPC Medical College and Hospital, Kolkata, West Bengal, India
2 Department of Psychiatry, Bongaon J R Dhar Sub Divisional Hospital, Bongaon, West Bengal, India
3 Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India

Correspondence Address:
Dr. Suddhendu Chakraborty
Department of Psychiatry, Bongaon J R Dhar Sub Divisional Hospital, Bongaon - 743 235, 24 Paraganas (North), West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/psychiatry.IndianJPsychiatry_421_19

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Background: Post stroke depression adversely affects long term outcome of stroke and increases mortality risk. Few studies have looked into the comprehensive picture of post stroke depression in past. Aim: The current study aimed to look into the phenomenology, characteristic features and various correlates of post stroke depression. Method: 142 consecutive stroke patients aged 60 years or above, fulfilling the inclusion criteria were assessed. Sociodemographic and clinical data were gathered using a specially designed pro-forma. Depression, apathy and psychosis were assessed by Post stroke depression rating scale, Apathy Evaluation Scale, and Brief Psychiatric Rating Scale respectively. Groups (with or without major depression) were compared using Mann-Whitney U, chi square or Fisher's exact test. One way ANOVA was conducted to see the relations of lesion location and laterality with various clinical parameters. Kaplan-Meier survival analysis was done to see the time to develop depression. The effect sizes were reported as r and partial eta squared. Results: Guilt was significantly higher (p<.05) with lesions in parietal lobe and remaining of middle cerebral artery territory. Catastrophic reaction (p<.05) and emotional dyscontrol (p<.05) were higher for diffuse lesions, periventricular lesions and lesions in frontal/occipital lobe. BPRS score, but not apathy, had a significant positive correlation with depression (Pearson's r=.692). Mean time to develop depression after stroke was 28.34 (95% CI 22.37 to 34.31) months. Conclusions: Post stroke depression consists of various clinically important sub-components whose occurrence varies with different lesion locations. Post stroke depression is discriminable from apathy but is related to psychosis.



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