Poststroke depression and rehabilitation outcome

Depression is the commonest psychiatric reaction after a stroke. It has been suggested that poststroke depression should be taken into account in clinical practice because of its potentially negative impact on the quality of life after a stroke, on the patient's participation in the rehabilitation process, and on the associated rehabilitation outcome. We studied 246 (48%) of 511 ischaemic stroke patients who had been diagnosed at the Department of Neurology at Kuopio University Hospital during 1988-1989. The rehabilitation outcome of depressed patients after 2 1/2 months' follow-up was similar to that in nondepressed patients. However, those patients who had a psychiatric disorder in their medical history before ischaemic stroke had a poorer rehabilitation outcome. Depression did not correlate with the patient's other earlier clinical diseases or sociodemographic background variables. Furthermore, those who were diagnosed as having depression during the follow-up visit performed worse than nondepressed patients in the activities of daily living and ambulation. We conclude that the diagnosis and treatment of poststroke depression is essential in clinical practice because of its negative impact on rehabilitation outcome, especially in patients with prestroke psychiatric disorders.