香港腦卒中患者抑郁狀態及其影響因素的縱向調查_《中國循證醫學雜志》

作者：

 薛詠紅 ¹ , 汪國成 ¹ , 李常威 ²

1. 香港理工大學護理學院 2. 香港醫院管理局，東華醫院;

關鍵詞：

卒中后抑郁社會支持功能殘疾

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　腦卒中后抑郁狀態是常見的精神衛生問題，應引起臨床醫護人員的關注。本文旨在探討影響首次卒中患者出現卒中后抑郁的相關因素。
方法　采用6個月縱向研究設計，共選定兩個觀察時間點：T1，入住康復病房后的48 h內；T2，相距T1后的第6個月。數據收集均于受試者當時的居住地進行。納入居住在香港特別行政區首次患腦中卒的患者（除外伴有意識障礙或失語癥）。
結果　T1和T2時卒中后抑郁的發生率分別為69％和48％。向后線性回歸分析發現，共有5個變量可解釋T2時卒中后抑郁55％的差異。其相關因素包括：在T1時抑郁癥狀的水平（P lt;0.001）、患者社會角色在病前為居家主婦（P=0.039）、在T2時的功能殘疾水平（P lt;0.001）、獲得的信息支持（P=0.025）及朋輩間的交誼支持（P=0.001）。
結論　本研究的結果表明，卒中后抑郁可以是因卒中致殘及家庭角色改變而出現的一種精神衛生問題。心理及社會支持是照顧護理腦卒中患者時不可或缺的一部份。

引用本文： 薛詠紅,汪國成,李常威. 香港腦卒中患者抑郁狀態及其影響因素的縱向調查. 中國循證醫學雜志, 2006, 06(4): 243-248. doi: 復制

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2.	Collaboration. Self-reported depression and use of antidepressants after stroke: a national survey.Stroke, 2004; 35(4): 936-941.
3.	鄔夢龍，陳國義，態生才.20例腦卒中抑郁狀態初步分析。中國神經精神疾病雜志, 1994; 20(2), 109-110.
4.	Robinson RG, Starr LB, Lipsey JR, et al. A two-year longitudinal study of post-stroke mood disorders: dynamic changes in associated variables over the first six months of follow-up.Stroke, 1984; 15(3): 510-7.
5.	Herrmann M, Bartels C, Schumacher M, et al. Poststroke depression. Is there a pathoanatomic correlate for depression in the postacute stage of stroke? Stroke, 1995; 26(5): 850-856.
6.	Morris PL, Robinson RG, de Carvalho ML, et al. Lesion characteristics and depressed mood in the stroke data bank study. J Neuropsychiatry Clin Neurosci, 1996; 8(2): 153-159.
7.	MacHale SM, O’Rourke SJ, Wardlaw JM, et al. Depression and its relation to lesion location after stroke. J Neurol Neurosurg Psychiatry, 1998, 64(3): 371-374.
8.	Eriksson M, Asplund K, Glader EL, et al. Riks-Stroke.
9.	Bhogal SK, Teasell R, Foley N, et al. Lesion location and poststroke depression: systematic review of the methodological limitations in the literature. Stroke, 2004; 35(3): 794-802.
10.	Jorgensen HS, Nakayama H, Raaschou HO, et al. Outcome and time course of recovery in stroke. Part II: Time course of recovery. The Copenhagen Stroke Study. Arch Phys Med Rehabil. 1995; 76(5): 406-412.
11.	American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) (4th ed). 2000.
12.	De Coster L, Leentjens AF, Lodder J, et al. The sensitivity of somatic symptoms in post-stroke depression: a discriminant analytic approach. Int J Geriatr Psychiatry, 2005; 20(4): 358-362.
13.	Radloff LS.The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1977; 3 (1); 385-401.
14.	Chi I, Boey KW.A mental health and social support study of the old-old in Hong Kong (Resource paper series No.22). Hong Kong: University of Hong Kong Department of Social Work and Social Administration. 1994.
15.	Kuo WH. Prevalence of depression among Asian-Americans. J Nerv Ment Dis, 1984; 172(8): 449-457.
16.	Ramasubbu R, Robinson RG, Flint AJ, et al. Functional impairment associated with acute poststroke depression: the Stroke Data Bank Study. J Neuropsychiatry Clin Neurosci, 1998; 10(1): 26-33.
17.	Shinar D, Gross CR, Price TR, et al. Screening for depression in stroke patients: the reliability and validity of the Center for Epidemiologic Studies Depression Scale. Stroke, 1986; 17(2): 241-245.
18.	Parikh RM, Eden DT, Price TR, et al. The sensitivity and specificity of the Center for Epidemiologic Studies Depression Scale in screening for post-stroke depression. Int J Psychiatry Med, 1988; 18(2): 169-181.
19.	MCDOWELL I, Newell C. Measuring Health. A Guide to Rating Scales and Questionnaires (2nd ed). New York: Oxford University Press. 1996.
20.	Wade DT, Hewer RL. Functional disabilities after stroke: Measuring natural history and prognosis. Journal of Neurology, Neurosurgery and Psychiatry, 1987; 50: 177-182.
21.	Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol, 1989; 42(8): 703-709.
22.	Wityk RJ, Pessin MS, Kaplan RF, et al. Serial assessment of acute stroke using the NIH Stroke Scale. Stroke, 1994; 25(2): 362-365.
23.	Suurmeijer TP, Doeglas DM, Briancon S, et al. The measurement of social support in the ’European Research on Incapacitating Diseases and Social Support’: the development of the Social Support Questionnaire for Transactions (SSQT). Soc Sci Med, 1995; 40(9): 1221-1229.
24.	Sit JW, Wong TK, Clinton M, et al. Stroke care in the home: the impact of social support on the general health of family caregivers. J Clin Nurs, 2004; 13(7): 816-824.
25.	Fuh JL, Liu HC, Wang SJ, et al. Poststroke depression among the Chinese elderly in a rural community. Stroke, 1997 Jun;28(6):1126-1129.
26.	ZHANG, Q. A correlative study on post-stroke depression and CT, physical, psychological and social parameters. Zhonghua Shen Jing Jing Shen Ke Za Zhi. 1992; 25(4): 203-207, 252. Chinese.
27.	Tang WK, Chan SS, Chiu HF, et al. Can the Geriatric Depression Scale detect poststroke depression in Chinese elderly? J Affect Disord, 2004; 81(2): 153-156.
28.	House A. Mood disorders after stroke: A review of the evidence. International Journal of Geriatric Psychiatry, 1987; 2: 211-221.
29.	House A, Dennis M, Hawton K, et al. Methods of identifying mood disorders in stroke patients: experience in the Oxfordshire Community Stroke Project. Age Ageing, 1989; 18(6): 371-379.
30.	House A, Dennis M, Warlow C, et al. Mood disorders after stroke and their relation to lesion location. A CT scan study. Brain, 1990; 113 ( Pt 4): 1113-1129.
31.	Morris PL, Raphael B, Robinson RG. Clinical depression is associated with impaired recovery from stroke. Med J Aust, 1992; 157(4): 239-242.
32.	Herrmann N, Black SE, Lawrence J, et al. The Sunnybrook Stroke Study: a prospective study of depressive symptoms and functional outcome. Stroke, 1998; 29(3): 618-624.
33.	Cassidy EM, O’connor R, O’eane V. Prevalence of post-stroke depression in an Irish participant and its relationship with disability and outcome following inpatient rehabilitation. Disability and Rehabilitation, 2004; 26: 71-77.
34.	Wade DT, Legh-Smith J, Hewer RA. Depressed mood after stroke. A community study of its frequency. Br J Psychiatry; 1987; 151: 200-205.
35.	Carod-Artal J, Egido JA, Gonzalez JL, et al. Quality of life among stroke survivors evaluated 1 year after stroke: experience of a stroke unit. Stroke, 2000; 31(12): 2 995-3 000.
36.	Chou KL, Chi I. Reciprocal relationship between social support and depressive symptoms among Chinese elderly. Aging Ment Health, 2003; 7(3): 224-231.
37.	Chou KL, Chi I. Chronic illness and depressive symptoms among Chinese older adults: a longitudinal study. Int J Aging Hum Dev, 2002;54(2):159-171.

1. WU ML,CHENG GY,TAI SC. Primary analysis of post stroke depression in 20 patients. Zhong Guo Shen Jing Ji Bing Za Zhi. 1994; 20(2), 109-110.
2. Collaboration. Self-reported depression and use of antidepressants after stroke: a national survey.Stroke, 2004; 35(4): 936-941.
3. 鄔夢龍，陳國義，態生才.20例腦卒中抑郁狀態初步分析。中國神經精神疾病雜志, 1994; 20(2), 109-110.
4. Robinson RG, Starr LB, Lipsey JR, et al. A two-year longitudinal study of post-stroke mood disorders: dynamic changes in associated variables over the first six months of follow-up.Stroke, 1984; 15(3): 510-7.
5. Herrmann M, Bartels C, Schumacher M, et al. Poststroke depression. Is there a pathoanatomic correlate for depression in the postacute stage of stroke? Stroke, 1995; 26(5): 850-856.
6. Morris PL, Robinson RG, de Carvalho ML, et al. Lesion characteristics and depressed mood in the stroke data bank study. J Neuropsychiatry Clin Neurosci, 1996; 8(2): 153-159.
7. MacHale SM, O’Rourke SJ, Wardlaw JM, et al. Depression and its relation to lesion location after stroke. J Neurol Neurosurg Psychiatry, 1998, 64(3): 371-374.
8. Eriksson M, Asplund K, Glader EL, et al. Riks-Stroke.
9. Bhogal SK, Teasell R, Foley N, et al. Lesion location and poststroke depression: systematic review of the methodological limitations in the literature. Stroke, 2004; 35(3): 794-802.
10. Jorgensen HS, Nakayama H, Raaschou HO, et al. Outcome and time course of recovery in stroke. Part II: Time course of recovery. The Copenhagen Stroke Study. Arch Phys Med Rehabil. 1995; 76(5): 406-412.
11. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) (4th ed). 2000.
12. De Coster L, Leentjens AF, Lodder J, et al. The sensitivity of somatic symptoms in post-stroke depression: a discriminant analytic approach. Int J Geriatr Psychiatry, 2005; 20(4): 358-362.
13. Radloff LS.The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1977; 3 (1); 385-401.
14. Chi I, Boey KW.A mental health and social support study of the old-old in Hong Kong (Resource paper series No.22). Hong Kong: University of Hong Kong Department of Social Work and Social Administration. 1994.
15. Kuo WH. Prevalence of depression among Asian-Americans. J Nerv Ment Dis, 1984; 172(8): 449-457.
16. Ramasubbu R, Robinson RG, Flint AJ, et al. Functional impairment associated with acute poststroke depression: the Stroke Data Bank Study. J Neuropsychiatry Clin Neurosci, 1998; 10(1): 26-33.
17. Shinar D, Gross CR, Price TR, et al. Screening for depression in stroke patients: the reliability and validity of the Center for Epidemiologic Studies Depression Scale. Stroke, 1986; 17(2): 241-245.
18. Parikh RM, Eden DT, Price TR, et al. The sensitivity and specificity of the Center for Epidemiologic Studies Depression Scale in screening for post-stroke depression. Int J Psychiatry Med, 1988; 18(2): 169-181.
19. MCDOWELL I, Newell C. Measuring Health. A Guide to Rating Scales and Questionnaires (2nd ed). New York: Oxford University Press. 1996.
20. Wade DT, Hewer RL. Functional disabilities after stroke: Measuring natural history and prognosis. Journal of Neurology, Neurosurgery and Psychiatry, 1987; 50: 177-182.
21. Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol, 1989; 42(8): 703-709.
22. Wityk RJ, Pessin MS, Kaplan RF, et al. Serial assessment of acute stroke using the NIH Stroke Scale. Stroke, 1994; 25(2): 362-365.
23. Suurmeijer TP, Doeglas DM, Briancon S, et al. The measurement of social support in the ’European Research on Incapacitating Diseases and Social Support’: the development of the Social Support Questionnaire for Transactions (SSQT). Soc Sci Med, 1995; 40(9): 1221-1229.
24. Sit JW, Wong TK, Clinton M, et al. Stroke care in the home: the impact of social support on the general health of family caregivers. J Clin Nurs, 2004; 13(7): 816-824.
25. Fuh JL, Liu HC, Wang SJ, et al. Poststroke depression among the Chinese elderly in a rural community. Stroke, 1997 Jun;28(6):1126-1129.
26. ZHANG, Q. A correlative study on post-stroke depression and CT, physical, psychological and social parameters. Zhonghua Shen Jing Jing Shen Ke Za Zhi. 1992; 25(4): 203-207, 252. Chinese.
27. Tang WK, Chan SS, Chiu HF, et al. Can the Geriatric Depression Scale detect poststroke depression in Chinese elderly? J Affect Disord, 2004; 81(2): 153-156.
28. House A. Mood disorders after stroke: A review of the evidence. International Journal of Geriatric Psychiatry, 1987; 2: 211-221.
29. House A, Dennis M, Hawton K, et al. Methods of identifying mood disorders in stroke patients: experience in the Oxfordshire Community Stroke Project. Age Ageing, 1989; 18(6): 371-379.
30. House A, Dennis M, Warlow C, et al. Mood disorders after stroke and their relation to lesion location. A CT scan study. Brain, 1990; 113 ( Pt 4): 1113-1129.
31. Morris PL, Raphael B, Robinson RG. Clinical depression is associated with impaired recovery from stroke. Med J Aust, 1992; 157(4): 239-242.
32. Herrmann N, Black SE, Lawrence J, et al. The Sunnybrook Stroke Study: a prospective study of depressive symptoms and functional outcome. Stroke, 1998; 29(3): 618-624.
33. Cassidy EM, O’connor R, O’eane V. Prevalence of post-stroke depression in an Irish participant and its relationship with disability and outcome following inpatient rehabilitation. Disability and Rehabilitation, 2004; 26: 71-77.
34. Wade DT, Legh-Smith J, Hewer RA. Depressed mood after stroke. A community study of its frequency. Br J Psychiatry; 1987; 151: 200-205.
35. Carod-Artal J, Egido JA, Gonzalez JL, et al. Quality of life among stroke survivors evaluated 1 year after stroke: experience of a stroke unit. Stroke, 2000; 31(12): 2 995-3 000.
36. Chou KL, Chi I. Reciprocal relationship between social support and depressive symptoms among Chinese elderly. Aging Ment Health, 2003; 7(3): 224-231.
37. Chou KL, Chi I. Chronic illness and depressive symptoms among Chinese older adults: a longitudinal study. Int J Aging Hum Dev, 2002;54(2):159-171.

《中國循證醫學雜志》

香港腦卒中患者抑郁狀態及其影響因素的縱向調查

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《中國循證醫學雜志》

香港腦卒中患者抑郁狀態及其影響因素的縱向調查

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料