Depression and Functional Outcome After Stroke: the Effect of Antidepressant Therapy on Functional Recovery

Aim: The optimal strategy to prevent post-stroke depression is an important but still-unresolved issue. This study examined the differences in functional recovery among post-stroke depressed patients (DP) compared to post-stroke non-depressed patients (NDP) over the course of six months after stroke.

Methods: On the basis of a semistructured psychiatric examination, DSM-IV diagnostic criteria and the Hamilton Depression score, a consecutive series of ischemic or hemorrhagic stroke patients were included in this study. They had suffered from first-time stroke, and did not have depression diagnosis before. During follow-up, treatment with 20 mg/day citalopram per os was initiated whenever a diagnosis of depression was established. Their functional recoveries were assessed using the Scandinavian Stroke Scale, the modified Rankin scale and the Barthel index during acute hospitalization, at the time of depression diagnosis and at the third and sixth month follow-up visits.

Results: Forty patients met the diagnostic criteria and 11 patients suffered from depression during the follow-up period. There were no differences in demographic variables, lesion characteristics and neurological symptoms between DP and NDP. Functional recovery in DP was impaired in comparison to NDP (P<0.05). All DP, whose mood improved after administration of citalopram, and improved daily functions living functions during the follow-up.

Conclusion: This study's findings suggest that remission of post-stroke depression is associated with improvement in functional recovery. Early diagnosis and effective treatment of depression will help the rehabilitation outcome of stroke patients.