脑卒中后抑郁与卒中部位关系探讨

目的 研究首发脑卒中患者第4周脑卒中后抑郁与卒中部位的关系.方法 共调查127例患者,其中113例完成所有调查,将诊断为PSD的患者列为PSD组,其余患者为非PSD组.比较2组的卒中性质和卒中部位.结果 从卒中病灶发生的部位看,左侧病灶发病率(59.18%)高于右侧病灶(38.16%),前部病灶(50.85%)高于后部病灶(29.63%).皮层病灶(57.14%)高于皮层下病灶(33.80%).2组病灶数目比较,多灶患者PSD的发生率(59.68%)明显高于单灶患者(37.25%)(P<0 .05).卒中性质与PSD无明显关系(χ2＝3.86,P>0.05).结论 脑卒中后抑郁与卒中部位存在关系.     

卒中后抑郁与脑损伤部位相关性的临床研究

目的探讨不同的脑损伤部位与脑卒中后抑郁病变的关系,探讨PSD的现况以及对结局的影响。方法收集2010年09月～2011年09月期间河北联合大学附属医院神经内科脑卒中患者300例,通过颅脑CT或MRI进行卒中病灶定位,采用Hamilton抑郁量表对卒中患者在发病14±2d及90±7d进行抑郁及程度的评价。对收集患者的相关临床指标如美国国立卫生院神经功能缺损评分(NIHSS)、改良Rankin量表评分(MRS)、简易精神状态检查表(MMSE)评分等相关因素进行统计分析。结果 140例脑卒中患者合并PSD,总发生率为46.67%,其中轻中度抑郁占46.00%,重度抑郁占0.67%;多发性、左侧半球、额颞叶、基底节区脑卒中患者PSD发生率高。结论脑卒中患者神经功能缺损程度评分越高,其患抑郁的程度也就越高。PSD发生与卒中类型无关,而与卒中部位、卒中残疾程度等因素有关。     

卒中后抑郁与卒中部位的相关研究

目的 探讨卒中后抑郁（post-stroke depression PSI））与卒中病灶部位的关系。方法通过CT或MRI进行卒中病灶定位,采用Hamilton抑郁量表对200例卒中患者在发病2周和3月进行调查评分。结果急性期和恢复期大脑半球左侧、右侧、双侧卒中PSD发生率无统计学差异。2周时大脑半球前部与后部卒中病灶两PSD发生率无统计学差异（x^2=1．9546,P〉0．1）。3月时大脑半球前部与后部卒中痛灶两PSD发生率有统计学差异（x^2=6．04,P〈0．05）。结论PSD的发生无半球偏利性。急性期大脑半球前部卒中病灶与PSD无明显相关性。恢复期走脑半球前部卒中病灶与PSD存在相关性。     

腔隙性脑梗死患者卒中后抑郁的临床分析

目的 探讨腔隙性脑梗死(腔梗)患者发生卒中后抑郁(PSD)的特点及其相关因素.方法 138例经CT和MRI证实的腔梗患者根据Hamilton抑郁量表(HAMD)、抑郁自评量表(SDS)评分分为PSD组及非PSD组;分析梗死灶的部位、数量、患者年龄、文化程度、神经功能缺损程度评分、伴发疾病等对PSD的影响.结果 本组PSD发生率为31.2％(43例);多为轻度抑郁,焦虑/躯体化症状为重;与非PSD组比较,PSD组患者年龄≥65岁、文化程度低、伴高血压病的比率以及神经功能缺损程度评分明显增高(P＜0.01 ～0.001);神经功能缺损程度评分与PSD正相关(r=0.988,P＜0.01).梗死灶多发或位于丘脑、尾状核、豆状核的患者PSD发生率显著高于单梗死灶或其位于皮质下白质的患者(均P＜0.01).结论 腔梗患者PSD多为轻度,焦虑/躯体化症状较重;PSD与病灶部位、病情以及文化程度等生物-心理-社会多因素有关.     

急性脑梗死患者抑郁与病灶部位的相关性研究

目的探讨脑梗死患者抑郁与病灶部位的关系。方法对78例脑梗死患者利用汉密顿抑郁量表(HAMD)进行检查后,将患者分为抑郁组和非抑郁对照组,选用磁共振成像(MRI)进行病灶部位和范围的检测,评定患者的抑郁与病灶部位的相关性。结果脑梗死患者抑郁的发生率为42.3%;2组患者大脑半球左侧和右侧比较,差异无统计学意义(P>0.05);前部和后部、皮层和皮层下比较,差异有统计学意义(P<0.05);大脑前、中动脉供血区比较,差异无统计学意义(P>0.05);大脑前、中动脉供血区与大脑后动脉供血区比较,差异有统计学意义(P<0.05)。结论脑梗死患者的抑郁与病灶部位有相关性,大脑半球前部、皮层损伤及大脑半球大脑前、中动脉供血区损伤,更可能导致抑郁。     

首次脑梗死患者卒中后抑郁的发生率及危险因素分析

目的探讨首次脑梗死(CI)患者卒中后抑郁的发生率及危险因素。方法连续入组的首次CI患者156例,根据发病7d、14d、3个月、6个月、1年,汉密尔顿抑郁量表HAMD(17项)评分分为卒中后抑郁(PSD)组和非PSD组,对首次PSD患者探讨PSD发生率,分析其独立变量,应用多元Logistic回归分析其危险因素。结果 (1)156例首次CI患者完成了随访,PSD的发生率为33.97%(53/156),在7d、14d、3个月、6个月、1年时确诊PSD例分别为:6、10、18、7、12例;(2)中、重度PSD组改良的Rankin量表(m RS)评分均较同期非PSD组升高;(3)41~60岁患者、入院时NIHSS评分大于20分是首次脑梗死患者卒中后抑郁的独立危险因素。结论首次CI患PSD的发生率为33.97%;41~60岁患者、入院时NIHSS评分大于20分是首CI患者卒中后抑郁的独立危险因素。     

脑卒中后抑郁与脑损伤部位相关性临床分析

目的探讨脑卒中患者抑郁的发生与损伤部位的关系。方法 2010-10—2011-10 150例脑卒中住院患者,全部通过临床症状及MRI检查对病灶定位,采用汉密尔顿抑郁量表对脑卒中患者进行抑郁评分。结果脑卒中后抑郁68例,发生率45.33%,其中左侧发生率高于右侧,以额颞叶、基底节区为主。结论脑卒中患者抑郁的发生与卒中部位密切相关,其中左侧大脑半球的额颞叶及基底节区相关性更为显著。     

卒中后抑郁的前瞻性随访调查

目的 研究卒中后抑郁(PSD)2周及3个月的患病率与相关因素.方法 对257例急性卒中患者进行2周及3个月前瞻性随访,调查卒中2周及3个月PSD患病率及相关因素.结果 卒中2周PSD患病率为32.59％,其中轻型抑郁20.92％,重型抑郁11.67％.卒中3个月PSD患病率为42.68％,其中轻型抑郁19.87％,重型抑郁22.81％.卒中2周PSD相关因素是人格特质中的内向特质(P=0.000)、是否合并有糖尿病(P=0.000)及神经功能缺损评分(P=0.000).卒中3个月PSD相关因素是急性期已经诊断PSD(P =0.000)及前循环卒中(P=0.04).结论 PSD患病率较高.卒中2周PSD发生与内向人格特质、合并糖尿病及神经缺损有关,3个月发生与急性期PSD及前循环卒中有关.     

首发急性脑卒中患者发病部位与3年内卒中后抑郁发病的相关性分析

目的 探讨首发急性脑卒中患者不同发病部位对病后较长时期卒中后抑郁发病的相关性分析.方法 选取2016-03—2017-05于新乡医学院第三附属医院首次确诊的148例脑卒中患者为研究对象,经治疗离院后持续随访时间>3 a,收集患者的人口学资料、影像学资料和出院后的运动功能、精神状态检查结果,观察术后3年内抑郁的发病情况和...     

轻度认知障碍与卒中后抑郁关系的研究进展

轻度认知障碍（mild cognitive impairment,MCI）是认知正常和痴呆之间的过渡状态,MCI与 卒中后抑郁（post-stroke depression,PSD）关系密切。MCI常伴发抑郁,而PSD亦被认为是MCI向痴呆进展 的重要危险因素。本文就MCI与PSD关系的研究进展进行综述,着重介绍MCI和PSD关系的新进展,包 括流行病学、相关机制及治疗。     

The relationship between risk factors for affective disorder and poststroke depression in hospitalised stroke patients.

The influence of psychiatric risk factors on the development of depression following stroke was examined in 88 patients undergoing inpatient rehabilitation. In this sample, 34 patients (38%) had a diagnosis of major or minor depression. Older age and a personal or family history of affective or anxiety disorder were associated significantly with major depression. Minor depression was more common among males and those patients with greater physical disability. Severity of depressive symptoms was associated with a personal or family history of affective or anxiety disorder and higher pre-stroke personality neuroticism. We conclude that certain psychiatric risk factors for affective disorder are strongly associated with poststroke depression. The implications of these findings for anticipating and managing poststroke depression are discussed.     

脑卒中与卒中后抑郁的关系研究

目的 通过调查脑卒中患者抑郁的发生率和抑郁与病灶部位、认知功能、日常生活能力及神经功能缺损程度之间的关系,探讨脑卒中后早期抑郁发生的情况及危险因素。方法 运用问卷调查的方法评估抑郁状态及认知功能状态,并根据临床体检结果判定日常生活能力及神经功能缺损程度。结果 脑卒中后早期抑郁的发生率为31．43％;抑郁与认知功能障碍之间有明显关系。抑郁与日常生活能力及神经功能缺损程度之间有明显关系。结论 脑卒中后早期即存在较普遍的抑郁情绪,抑郁与认知功能、日常生活能力及神经功能缺损程度之间存在显著关系。     

The assessment of poststroke depression

Poststroke depression (PSD) is a common clinical consequence of stroke. PSD is associated with poor functional and social outcomes, reduced quality of life, the presence of cognitive impairment, and increased mortality. Despite the potential benefit associated with the identification and treatment of PSD, it often remains unrecognized and undertreated. The present study provides a critical review and synthesis of measurement properties for 10 instruments used in the assessment of depression following stroke. Assessment considerations specific to PSD are addressed, and tools are reviewed within the context of stroke. To facilitate the timely detection, diagnosis, and initiation of treatment for PSD, a two-step assessment process is recommended, thereby taking strategic advantage of the strengths and limitations associated with self-report and observer-rating assessment tools.     

Social isolation poststroke: relationship between race/ethnicity, depression, and functional independence

Research suggests that individuals recovering from a stroke often experience social isolation, which is linked to increased depressive symptomatology and decreased ability to manage activities of daily living. Research also indicates that different racial and ethnic groups are more adversely affected than whites. This article uses poststroke narratives to explore the relationship between social isolation, depressive symptomatology, and the ability to manage activities of daily living poststroke for white, African American, and Puerto Rican veterans. Findings suggest those who were socially isolated during the first year of poststroke recovery reported higher levels of depressive symptoms and a decreased ability to manage daily activities. Implications for stroke rehabilitation practice are discussed.     

社区脑卒中患者抑郁与日常生活活动能力的相关性研究

目的探讨社区脑卒中患者抑郁与日常生活活动能力的相关性及日常生活活动能力的影响因素。方法随机抽取郑州市5个社区的脑卒中患者共146例,分别用抑郁自评量表(Self-rating Depression Scale,SDS)和Barthel指数评定量表测评脑卒中患者的抑郁水平和日常生活活动能力(Activity of daily living,ADL)。结果社区脑卒中患者抑郁得分处中等水平(40.48±10.69分),抑郁发生率为44.5%;日常生活活动能力得分较高(74.45±31.21分),整体处于良好水平。相关分析显示抑郁与ADL呈负相关(r=-0.402,P<0.01);多元回归分析显示影响脑卒中患者ADL的因素有抑郁水平、是否接受过康复指导、中风次数及患者年龄。结论抑郁会阻碍脑卒中患者日常生活活动能力的提高,医护人员应该在脑卒中发作后及时改善抑郁状况,给予医院及社区康复指导,提高脑卒中患者回归社区后的日常生活活动能力。     

The relationship between suicidality and depression

Abstract

According to psychiatric classification systems and most influential psychological theories a close pathogenetic and/or causal relationship exists between suicidality and depression. However, upon reviewing the available empirical literature with respect to epidemiologic. post mortem, risk factor, follow-up, family, twin, adoption, biological, and therapy studies, this postulated close relationship could not be confirmed. Factors such as presence of any psychiatric disorder and personality traits such as impulsivity, aggressivity, addiction and suicide/suicide attempts in first degree relatives. as well as divorce, separation and parental discord, all seem to play an important role in the pathogenesis of suicidal behaviour. Furthermore, treatment studies with antidepressants, ECT, and lithium have only been able to demonstrate an antisuicidal effect for lithium. It remains an open question whether these factors play a independent role from depression or whether these factors have to be seen as additional to the depression. as operating factors for the development of suicide ideas. suicide attempts and suicide.     

Prevention and treatment of poststroke depression with mirtazapine in patients with acute stroke

BACKGROUND AND OBJECTIVE: Poststroke depression is one of the most frequent complications of stroke, affecting approximately 20% to 40% of all patients. In spite of the importance of this neuropsychiatric disorder, little attention has been given to the prevention of poststroke depression. The purpose of this study was to examine whether prophylactic treatment with the antidepressant mirtazapine in patients with acute stroke given from day 1 after the incidence prevents poststroke depression. METHOD: Patients with ischemic stroke received either 30 mg mirtazapine or no antidepressant medication from day 1 after the stroke in an open, randomized study design. Data were collected from August 2001 to December 2002. Seventy patients were enrolled in the study and were reexamined on days 7, 44, 90, 180, 270, and 360 using neurologic, functional, and depression rating scales. Those poststroke patients who developed depression (DSM-IV criteria) but had been randomly assigned to the nontreatment group were given the antidepressant mirtazapine after the diagnosis of depression had been established. RESULTS: Forty percent (14/35) of the nontreated patients and only 5.7% (2/35) of the patients who were treated with mirtazapine developed poststroke depression. Altogether, 16 patients developed poststroke depression, 15 of whom remitted after initiation of treatment with mirtazapine. CONCLUSION: Mirtazapine significantly reduced the rate of poststroke depression in patients with acute stroke. The study also demonstrated that this antidepressant was highly effective in treating poststroke depression.