Posts Tagged post-stroke depression

[ARTICLE] Effect of social support and health education on depression scale scores of chronic stroke patients – Full Text

Abstract

Post-stroke depression (PSD) constitutes an important complication of stroke, leading to great disability. After stroke, the prevalence rate of depression is about 30%. Depression also affects rehabilitation motivation, delays function recovery, and increases family and social burden. The objective of this study was to explore the effect of social support on depression in chronic stroke patients and the relationship between demographic and disease characteristics. Total samples were randomly divided into an intervention group (n = 31) and a control group (n = 31). Sixteen social support interventions were performed over 8 weeks. Social support programs were implemented 2 times a week. Depressive symptoms were assessed at the second week, 4th week, 8th week, and 4 weeks after the end of the study using the 10-item Center for the Epidemiological Studies of Depression Short Form (CES-D10). There was a significant correlation between depression and the economic status of the patients with chronic stroke, satisfaction in leisure, the presence or absence of caregivers, the duration of stroke, and with or without pain. A significant difference was found between two groups after social support for 8 weeks. Our findings suggest that remission of PSD needs at least 8 weeks of social support.

1 Introduction

Stroke is the third leading cause of death in Taiwan. After an acute stage, stroke patients usually suffer from physical, mental, verbal and social function disorders in varying degrees; in particular, post-stroke depression (PSD) is not only an important sequela, but also an important factor to predict the quality of life. Epidemiological studies have shown that about 30% of stroke patients at early or late stages develop PSD, which affects rehabilitation motivation of the patients, reduce the rehabilitation effect, and increase the load of family care. Although PSD affects the quality of life and functional recovery, it is often overlooked.[1] According to statistical data, the prevalence of depression is about 29% within 10 years after stroke, and the 5-year cumulative incidence is about 39% to 52%.[2] In a study on PSD and post-stroke fatigue of 368 stroke patients hospitalized within 3 months, researchers found that brain damage could result in physiological and psychological impairments. To be able to live independently, patients should learn the skills of adaptation, including the ability to seek social resources.[3] Successful rehabilitation means patients are able to maintain original social relations and actively participate in social activities to return to community life. Community social interaction or participation in activities requires physical and psychological ability.[4] In addition to rehabilitation activities, functional therapists should also meet the psychological needs of stroke patients in order to achieve holistic health care. In this study, we have investigated the effects of routine rehabilitation activities and additional social support and health education by functional therapists on PSD, and proposed suggestions on home and rehabilitation-related activities.[5,6][…]

 

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[Abstract] Efficacy and Safety of High-frequency Repetitive Transcranial Magnetic Stimulation for Post-Stroke Depression:A Systematic Review and Meta-Analysis

Abstract

Objective

To summarize and systematically review the efficacy and safety of high frequency repetitive transcranial magnetic stimulation (HF-rTMS) for depression in stroke patients.

Data Sources

Six databases (Wanfang, CNKI, PubMed, Embase, Cochrane Library, and Web of Science) were searched from inception until November 15, 2018.

Study Selection

Seventeen randomized controlled trials were included for meta-analysis.

Data Extraction

Two independent reviewers selected potentially relevant studies based on the inclusion criteria, extracted data, and evaluated the methodological quality of the eligible trials using the Physiotherapy Evidence Database (PEDro).

Data Synthesis

We calculated the combined effect size (standardized mean difference [SMD] and odds ratio [OR]) for the corresponding effects models. Physiotherapy Evidence Database scores ranged from 7 to 8 points (mean = 7.35). The study results indicated that HF-rTMS had significantly positive effects on depression in stroke patients. The effect sizes of the SMD ranged from small to large (SMD = −1.01; 95% confidence interval [95% CI], −1.36 to −0.66; P < .001; I2 = 85%; n = 1053), and the effect sizes of the OR were large (response rates: 58.43% VS 33.59%; OR = 3.31; 95% CI, 2.25 to 4.88; P < .001; I2 = 0%; n = 529; remission rates: 26.59% VS 12.60%; OR = 2.72; 95% CI, 1.69 to 4.38; P < .001; I2 = 0%; n = 529). In terms of treatment side-effects, the HF-rTMS group was more prone to headache than the control group (OR = 3.53; 95% CI, 1.85 to 8.55; P < .001; I2 = 0%; n = 496).

Conclusions

HF-rTMS is an effective intervention for post-stroke depression, although treatment safety should be further verified via large sample multi-center trials.

via Efficacy and Safety of High-frequency Repetitive Transcranial Magnetic Stimulation for Post-Stroke Depression:A Systematic Review and Meta-Analysis – Archives of Physical Medicine and Rehabilitation

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