NDLI: Assessment of depression after stroke: a comparison of different screening instruments.

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Assessment of depression after stroke: a comparison of different screening instruments.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Lönnqvist, Jouko Palomäki, Heikki Kaste, Markku Berg, Anu
Description	Country affiliation: Finland Author Affiliation: Berg A ( Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland. anu.berg@ekshp.fi)
Abstract	BACKGROUND AND PURPOSE: Assessing poststroke depression may be complicated by aphasia, other cognitive deficits, and several somatic stroke-related symptoms. We studied the possible differences in performance of some commonly used instruments in screening depression after stroke. METHODS: We compared the Beck Depression Inventory, Hamilton Rating Scale for Depression, Visual Analogue Mood Scale, proxy assessment, and Clinical Global Impression of the nursing and study personnel, together with Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, Revised diagnosis, in assessing depression after stroke in a follow-up study of 100 patients. The patients were studied at 2 weeks and at 2, 6, 12, and 18 months after stroke. RESULTS: The feasibility rates of all assessment instruments studied were fairly similar, but the prevalence rates differed according to the assessment instruments, varying from the lowest rates with a Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, Revised-based diagnosis up to 3-fold with caregiver ratings. The sensitivity and specificity against the Diagnostic and Statistical Manual of Mental Disorders criteria were acceptable with the Clinical Global Impression, Beck Depression Inventory, and Hamilton Rating Scale for Depression, mostly in the range of 0.70 to 1.00. The caregiver ratings were higher than the patient ratings (P<0.001) and correlated with the caregiver's own Beck Depression Inventory (0.60 to 0.61, P<0.001). The Visual Analogue Mood Scale was not a sensitive instrument (sensitivity, 0.20 to 0.60) and did not correlate with the Beck Depression Inventory during the first year after stroke. CONCLUSIONS: Beck Depression Inventory, Hamilton Rating Scale for Depression, and Clinical Global Impression assessment by professionals, in addition to the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, Revised diagnosis, are useful in assessing depression, but none of these instruments clearly stood apart from the others. Proxy ratings should be used with caution, and the use of the Visual Analogue Mood Scale among patients with aphasia and other cognitive impairments cannot be recommended.
ISSN	00392499
e-ISSN	15244628
Journal	Stroke
Issue Number	2
Volume Number	40
Language	English
Publisher	Lippincott Williams & Wilkins (on behalf of the American Heart Association)
Publisher Date	2009-02-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Depression Diagnosis Psychology Psychiatric Status Rating Scales Stroke Complications Acute Disease Physiology Caregivers Chronic Disease Etiology Depressive Disorder, Major Comparative Study Research Support, Non-u.s. Gov't Discipline Cardiology
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Neuroscience Advanced and Specialized Nursing Neurology (clinical)

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