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Medicineworld.org: Managing post-stroke depression

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Managing post-stroke depression




Stroke patients who are not successfully treated for depression are at higher risk of losing some of their capability to function normally, as per a research studyin the March 15, 2011 issue of the journal Neurology
Eventhough as a number of as a third of those who experience a stroke develop depression, a newly released study by scientists from the Regenstrief Institute, the schools of health and rehabilitation sciences and of medicine at Indiana University-Purdue University Indianapolis and the Richard L. Roudebush VA Medical Center is the first to look whether managing post-stroke depression improves physical functioning.



Managing post-stroke depression
Arlene A. Schmid, Ph.D., is a Regenstrief Institute investigator, an assistant professor of occupational therapy at the IU School of Health and Rehabilitation Science and a VA Center of Excellence on Implementing Evidence Based Practice investigator.

Credit: Regenstrief Institute

Usage Restrictions: Photo credit to Regenstrief Institute


They scientists report that individuals who remain depressed three months after a stroke are more likely to have decreased functional capabilities than those whose depression was successfully treated. Functional capabilities include getting dressed, feeding oneself, and accomplishing other tasks. These capabilities increased significantly in those people who were treated for depression.

Post-stroke depression may be associated with chemical changes in the brain, clinical evidence indicates.

"The relationship between post-stroke depression and recovery of function after a stroke has not been well understood. Prior scientists have looked at both depression and function after stroke but they did not investigate whether identifying and managing depression improved ability to accomplish tasks of daily living and other function related issues," said study first author Arlene A. Schmid, Ph.D., a Regenstrief Institute investigator, an assistant professor of occupational treatment at the IU School of Health and Rehabilitation Sciences and a VA Center of Excellence on Implementing Evidence Based Practice investigator.

The scientists in the newly released study report that successful depression management led to better functionality that might enable the individual to return to work or more thoroughly enjoy leisure functions while decreasing the caregiver burden.

"Restoring lost function after stroke is the number one reason individuals visit occupational therapists," said Dr. Schmid. "Since treating depression helps improve function, occupational therapists should screen for post-stroke depression and, in conjunction with other members of the patient's health care team, help manage depression".

In the Neurology study, whether an individual was depressed or not was determined through use of the Health Questionnaire-9 (PHQ-9), a widely used and easy to administer depression screening tool. The PHQ-9 was originally developed by Kurt Kroenke, M.D., a Regenstrief Institute investigator and IU School of Medicine professor of medicine. Dr. Kroenke, who is a co-author of the newly released study, has described the PhQ-9 as "a sort of a blood pressure cuff for depression".

As per Dr. Schmid, since occupational therapists are trained in mental health issues and see patients frequently, occupational therapists could use the PHQ-9 to screen for depression after stroke and alert a post-stroke patient's doctor to the individual's mental status.

In addition to improving functionality, management of depression would lower health care costs linked to functional impairment and other post-stroke therapy issues.

"Post-stroke depression often impacts quality of life after stroke more than even functional impairments. Since it is treatable with common medications, cognitive behavioral treatment and exercise, it is important to recognize it so patients can be treated. This study is one of the first to show not just the link between depression and worse function post-stroke, but that successfully treating depression symptoms actually improves post-stroke outcomes," said Linda S. Williams, M.D., a Regenstrief Institute investigator, associate professor of neurology at the IU School of Medicine, and a VA Center of Excellence on Implementing Evidence Based Practice investigator.


Posted by: Daniel    Source




Did you know?
Stroke patients who are not successfully treated for depression are at higher risk of losing some of their capability to function normally, as per a research studyin the March 15, 2011 issue of the journal Neurology Eventhough as a number of as a third of those who experience a stroke develop depression, a newly released study by scientists from the Regenstrief Institute, the schools of health and rehabilitation sciences and of medicine at Indiana University-Purdue University Indianapolis and the Richard L. Roudebush VA Medical Center is the first to look whether managing post-stroke depression improves physical functioning.

Medicineworld.org: Managing post-stroke depression

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