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Arch Phys Med Rehabil. 2015 Jun;96(6):1064-70. doi: 10.1016/j.apmr.2015.01.022. Epub 2015 Feb 12.

Psychological factors determine depressive symptomatology after stroke.

Author information

1
Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
2
Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands.
3
Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
4
Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands.
5
Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands. Electronic address: j.m.a.visser-meily@umcutrecht.nl.

Abstract

OBJECTIVE:

To identify psychological factors related to poststroke depressive symptoms.

DESIGN:

Cross-sectional study, with patients assessed at 2 months poststroke.

SETTING:

Patients with stroke from 6 general hospitals.

PARTICIPANTS:

Stroke patients (N=344; mean age ± SD, 66.9±12.3y).

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURES:

The presence of clinical depressive symptoms was determined with the depression subscale of the Hospital Anxiety and Depression Scale 2 months poststroke. Psychological factors assessed were extraversion, neuroticism, optimism, pessimism, self-efficacy, helplessness, acceptance, perceiving benefits, proactive coping, and passive coping.

RESULTS:

Bivariate correlations and multivariate backward logistic regression were used to analyze associations between psychological factors and poststroke depressive symptoms, accounting for demographic and stroke-related factors. More neuroticism, pessimism, passive coping, and helplessness, and less extraversion, optimism, self-efficacy, acceptance, perceived benefits, and proactive coping were bivariately associated with the presence of depressive symptoms. Multivariate logistic regression analysis showed that more helplessness (odds ratio [OR]=1.17) and passive coping (OR=1.19) and less acceptance (OR=.89) and perceived benefits (OR=.89) were independently significantly associated with the presence of poststroke depressive symptoms (Nagelkerke R(2)=.49).

CONCLUSIONS:

We found a relationship between psychological variables and the presence of depressive symptoms 2 months poststroke. It is important to take these factors into account during poststroke rehabilitation.

KEYWORDS:

Depression; Mental health; Psychology; Rehabilitation; Stroke

PMID:
25681672
DOI:
10.1016/j.apmr.2015.01.022
[Indexed for MEDLINE]

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