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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Activities of Daily Living, Aged, Antidepressive Agents, Cerebrovascular Disorders, Cognition, Cohort Studies, Depression, Disability Evaluation, Female, Humans, Male, Middle Aged, Psychological Tests, Time Factors.
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Is clinical depression associated with impaired recovery from stroke? Context: To examine the effect of clinical depression on recovery from stroke. We examined a cohort of inpatients with stroke initially at two months after their stroke and again 14 months later. Patients were included if they: (i) provided informed consent; (ii) were able to understand the interview questions; and (iii) survived to follow-up without suffering another stroke or major medical illness. Of 61 consecutive patients, 49 met these criteria. Depression was diagnosed using a structured clinical interview. Three aspects of recovery were measured: (i) functional status; (ii) activities of daily living; and (iii) cognitive performance. Twenty (41%) of the 49 patients were depressed at initial assessment. There were no significant differences in demographic, clinical, stroke or lesion characteristics between the depressed and non-depressed patients. At follow-up, depressed patients improved less than non-depressed patients in functional status (mean change from baseline, 23% versus 48%) (P = 0.001) and cognitive performance (-1% versus 11%) (P = 0.096). Mean recovery in activities of daily living was not different between the two groups (33% versus 32%) but more of the depressed patients deteriorated over time (20% versus 0%) (P = 0.047).
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Clinical depression occurring soon after stroke is associated with impaired recovery when patients are assessed 14 months later. Depression has a negative effect on recovery in functional status and cognitive performance and may produce deterioration in physical capacity in a number of patients. Physicians would be well advised to be alert for depression and intervene early. Effective treatment of depression may enhance stroke rehabilitation. Final Decision: yes