4.4 Article

The course of depressive symptoms in the first 12 months post-stroke and its association with unmet needs

Journal

DISABILITY AND REHABILITATION
Volume 44, Issue 3, Pages 428-435

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/09638288.2020.1769746

Keywords

Stroke; depression; depressive; monitoring; health services needs and demand; unmet needs

Categories

Funding

  1. Stichting Kwaliteitsgelden Medisch Specialisten [328534072014]

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Depressive symptoms in stroke patients are likely to persist or recur during the first 12 months post-stroke and are associated with unmet needs. Routine monitoring of depressive symptoms and unmet needs should be considered post-stroke.
Aim:To describe the course of depressive symptoms during the first 12 months post-stroke and its association with unmet needs. Methods:A prospective cohort study among stroke patients admitted to inpatient rehabilitation. Depressive symptoms were assessed 3, 6, and 12 months post-stroke using the Hospital Anxiety and Depression Scale, and categorized into three trajectories: no (all times <8), non-consistent (one or two times >= 8), or persistent (all times >= 8) depressive symptoms. Unmet needs were assessed using the Longer-Term Unmet Needs questionnaire. Multivariable logistic regression analyses were used to investigate the association between depressive symptoms and unmet needs. Results:One hundred and fifty-one patients were included, of whom 95 (62.9%), 38 (25.2%), and 18 (11.9%) had no, non-consistent, or persistent depressive symptoms, respectively. Depressive symptoms three months post-stroke persisted in 43.9% and recurred in 19.5% of patients during the first 12 months post-stroke. Depressive symptoms were significantly associated with the occurrence and number of unmet needs (odds ratio 6.49;p = 0.003 and odds ratio 1.28;p = 0.005, respectively). Conclusions:Depressive symptoms three months post-stroke were likely to persist or recur during the first 12 months post-stroke. Depressive symptoms are associated with unmet needs. These results suggest that routine monitoring of depressive symptoms and unmet needs should be considered post-stroke.

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