Psychological factors determine depressive symptomatology after stroke.

van Mierlo, Maria L; van Heugten, Caroline M; Post, Marcel W; de Kort, Paul L; Visser-Meily, Johanna M · Arch Phys Med Rehabil · 2015

cross_sectional · Level IV

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Abstract

To identify psychological factors related to poststroke depressive symptoms. Cross-sectional study, with patients assessed at 2 months poststroke. Patients with stroke from 6 general hospitals. Stroke patients (N=344; mean age ± SD, 66.9±12.3y). Not applicable. The presence of clinical depressive symptoms was determined with the depression subscale of the Hospital Anxiety and Depression Scale 2 months poststroke. Psychological factors assessed were extraversion, neuroticism, optimism, pessimism, self-efficacy, helplessness, acceptance, perceiving benefits, proactive coping, and passive coping. Bivariate correlations and multivariate backward logistic regression were used to analyze associations between psychological factors and poststroke depressive symptoms, accounting for demographic and stroke-related factors. More neuroticism, pessimism, passive coping, and helplessness, and less extraversion, optimism, self-efficacy, acceptance, perceived benefits, and proactive coping were bivariately associated with the presence of depressive symptoms. Multivariate logistic regression analysis showed that more helplessness (odds ratio [OR]=1.17) and passive coping (OR=1.19) and less acceptance (OR=.89) and perceived benefits (OR=.89) were independently significantly associated with the presence of poststroke depressive symptoms (Nagelkerke R(2)=.49). We found a relationship between psychological variables and the presence of depressive symptoms 2 months poststroke. It is important to take these factors into account during poststroke rehabilitation.

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