Changes in PHQ-9 depression scores in acute stroke patients shortly after returning home

<h4>Introduction</h4> Post-stroke depression is a disabling condition that occurs in approximately one-third of stroke survivors. There is limited information on changes in depressive symptoms shortly after stroke survivors return home. To identify factors associated with changes in post...

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Autores principales: Brent Strong, Michele C. Fritz, Liming Dong, Lynda D. Lisabeth, Mathew J. Reeves
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Publicado: Public Library of Science (PLoS) 2021
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spelling oai:doaj.org-article:9cbf7ed6367449c78ff95a47f9a0f6ad2021-11-18T08:14:33ZChanges in PHQ-9 depression scores in acute stroke patients shortly after returning home1932-6203https://doaj.org/article/9cbf7ed6367449c78ff95a47f9a0f6ad2021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584969/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4> Post-stroke depression is a disabling condition that occurs in approximately one-third of stroke survivors. There is limited information on changes in depressive symptoms shortly after stroke survivors return home. To identify factors associated with changes in post-stroke depressive symptoms during the early recovery period, we conducted a secondary analysis of patients enrolled in a clinical trial conducted during the transition period shortly after patients returned home (MISTT). <h4>Methods</h4> The Michigan Stroke Transitions Trial (MISTT) tested the efficacy of social worker case management and access to online information to improve patient-reported outcomes following an acute stroke. Patient Health Questionnaire-9 (PHQ-9) scores were collected via telephone interviews conducted at 7 and 90 days post-discharge; higher scores indicate more depressive symptoms. Generalized estimating equations were used to identify independent predictors of baseline PHQ-9 score at 7 days and of changes over time to 90 days. <h4>Results</h4> Of 265 patients, 193 and 185 completed the PHQ-9 survey at 7 and 90 days, respectively. The mean PHQ-9 score was 5.9 at 7 days and 5.1 at 90 days. Older age, being unmarried, and having moderate stroke severity (versus mild) were significantly associated with lower 7-day PHQ-9 scores (indicating fewer depressive symptoms). However, at 90 days, both unmarried patients and those with moderate or high stroke severity had significant increases in depressive symptoms over time. <h4>Conclusions</h4> In stroke patients who recently returned home, both marital status and stroke severity were associated with depressive symptom scores; however, the relationships were complex. Being unmarried and having higher stroke severity was associated with fewer depressive symptoms at baseline, but both factors were associated with worsening depressive symptoms over time. Identifying risk factors for changes in depressive symptoms may help guide effective management strategies during the early recovery period.Brent StrongMichele C. FritzLiming DongLynda D. LisabethMathew J. ReevesPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Brent Strong
Michele C. Fritz
Liming Dong
Lynda D. Lisabeth
Mathew J. Reeves
Changes in PHQ-9 depression scores in acute stroke patients shortly after returning home
description <h4>Introduction</h4> Post-stroke depression is a disabling condition that occurs in approximately one-third of stroke survivors. There is limited information on changes in depressive symptoms shortly after stroke survivors return home. To identify factors associated with changes in post-stroke depressive symptoms during the early recovery period, we conducted a secondary analysis of patients enrolled in a clinical trial conducted during the transition period shortly after patients returned home (MISTT). <h4>Methods</h4> The Michigan Stroke Transitions Trial (MISTT) tested the efficacy of social worker case management and access to online information to improve patient-reported outcomes following an acute stroke. Patient Health Questionnaire-9 (PHQ-9) scores were collected via telephone interviews conducted at 7 and 90 days post-discharge; higher scores indicate more depressive symptoms. Generalized estimating equations were used to identify independent predictors of baseline PHQ-9 score at 7 days and of changes over time to 90 days. <h4>Results</h4> Of 265 patients, 193 and 185 completed the PHQ-9 survey at 7 and 90 days, respectively. The mean PHQ-9 score was 5.9 at 7 days and 5.1 at 90 days. Older age, being unmarried, and having moderate stroke severity (versus mild) were significantly associated with lower 7-day PHQ-9 scores (indicating fewer depressive symptoms). However, at 90 days, both unmarried patients and those with moderate or high stroke severity had significant increases in depressive symptoms over time. <h4>Conclusions</h4> In stroke patients who recently returned home, both marital status and stroke severity were associated with depressive symptom scores; however, the relationships were complex. Being unmarried and having higher stroke severity was associated with fewer depressive symptoms at baseline, but both factors were associated with worsening depressive symptoms over time. Identifying risk factors for changes in depressive symptoms may help guide effective management strategies during the early recovery period.
format article
author Brent Strong
Michele C. Fritz
Liming Dong
Lynda D. Lisabeth
Mathew J. Reeves
author_facet Brent Strong
Michele C. Fritz
Liming Dong
Lynda D. Lisabeth
Mathew J. Reeves
author_sort Brent Strong
title Changes in PHQ-9 depression scores in acute stroke patients shortly after returning home
title_short Changes in PHQ-9 depression scores in acute stroke patients shortly after returning home
title_full Changes in PHQ-9 depression scores in acute stroke patients shortly after returning home
title_fullStr Changes in PHQ-9 depression scores in acute stroke patients shortly after returning home
title_full_unstemmed Changes in PHQ-9 depression scores in acute stroke patients shortly after returning home
title_sort changes in phq-9 depression scores in acute stroke patients shortly after returning home
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/9cbf7ed6367449c78ff95a47f9a0f6ad
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AT limingdong changesinphq9depressionscoresinacutestrokepatientsshortlyafterreturninghome
AT lyndadlisabeth changesinphq9depressionscoresinacutestrokepatientsshortlyafterreturninghome
AT mathewjreeves changesinphq9depressionscoresinacutestrokepatientsshortlyafterreturninghome
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