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Évolution clinique de la dépression post-accident vasculaire cérébral à Kinshasa
Authors:M Mpembi Nkosi  S Mampunza Ma Miezi  V Massamba Kubuta  T Matonda Ma Nzuzi  V Dubois  M-P De Partz  A Peeters  J Macq  E Constant
Institution:1. Département de psychiatrie, université catholique de Louvain, institut de recherche santé publique, santé et société, place de l’Université 1, 1348 Louvain-La-Neuve, Belgique;2. Département de psychiatrie, université de Kinshasa, Lemba, Kinshasa, Congo;3. École de santé publique, université Libre de Bruxelles, avenue Franklin-Roosevelt 50, 1050 Bruxelles, Belgique;4. Unité de neuropsychologie, université catholique de Louvain, cliniques universitaires Saint-Luc, avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Belgique;5. Département de neurologie, université catholique de Louvain, place de l’Université 1, 1348 Louvain-La-Neuve, Belgique;6. Université catholique de Louvain, institut de recherche santé publique santé et société, Clos Chapelle-aux-Champs, 30 boîte 3016, 1200 Bruxelles, Belgique
Abstract:

Objectives

To describe the evolution of the clinical profile of post-stroke depression over a period of one year and to determine factors associated with changes in post-stroke depression.

Methods

Prospective cohort study with a follow-up of 1 year including 30 consecutive eligible patients. The severity of depression was assessed with the patient health questionnaire (PHQ9).

Results

The mean age was 55.87 ± 12.67 years. Seventy percent of patients were men. The two assessments for neurological status, perceived health status and test results of attention were not statistically different. The rate of depressive symptoms was 26.67% in 2011 and 20% in 2012. Disability and apathy were significantly improved. The average for disability increased from 2.77 ± 1.19 to 2.46 ± 2.19 (P = 0.002). From 66.7% in 2011, the proportion of patients able to walk without assistance rose to 93.3% in 2012 (P = 0.03). In addition, the proportion of patients apathetic decreased from 43.3% to 13.3% (P = 0.01). Greater age, female sex, sleep disorders and post-stroke apathy remained associated with DPAVC between the two assessments, with an increase in the strength of the association for apathy.

Conclusions

The frequency of post-stroke depression is high and remains stable over time. Disability is the clinical feature that evolved more favorably. The association with apathy, present at the beginning, of the study was strengthened one year later.
Keywords:Accident vasculaire cé    bral    pression  Kinshasa  Invalidité    Apathie
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