Progress in Assessment of Post-stoke Depression

doi:10.3969/j.issn.1673-5765.2020.07.019

Abstract

Abstract:

The incidence of post-stroke depression (PSD) is high, and accurate assessment of PSD is helpful for clinical diagnosis and treatment. At present, PSD is assessed by using various scales. For stroke patients with normal speaking, Hamilton depression rating scale, post-stroke depression rating scale, and Montgomery-Asberg depression rating scale are the most widely used, which have high reliability and validity. For stroke patients with aphasia, although multiple PSD assessment scales have been developed, scales that can be used in clinical practice are relatively limited, of which the stroke aphasic depression questionnaire and the aphasic depression rating scale are relatively widely used. The assessment scales for PSD have different suitable population and evaluation indicators, what’s more, when using these scales, the raters pay more attention to depression than the primary disease-stroke, which may make patients feel discomfort and reject these evaluations so that the accuracy of the evaluation may be affected. Therefore, the limitations of these scales need to be resolved according to patients’ need in the future.

Key words: Stroke; Post-stroke depression; Assessment

摘要：

卒中后抑郁发病率较高，准确的评估有利于临床诊疗。目前，对卒中后抑郁的评估多依赖量表。对于不影响语言表达的卒中患者，汉密尔顿抑郁量表、卒中后抑郁分级量表和蒙哥马利抑郁量表应用最为广泛，且其信度和效度均较高。对于失语患者的卒中后抑郁评价量表虽然开发的比较多，但临床应用相对较局限，其中卒中失语抑郁问卷和失语抑郁评估量表应用相对较多。目前针对卒中后抑郁评估量表的应用人群、评估指标有所差异，在应用这些量表时，相比原发疾病，评估者更重视抑郁情绪的问题，这可能会造成患者的不配合和排斥，从而影响量表评价的准确性，这些局限性有待进一步研究解决。

关键词: 卒中; 卒中后抑郁; 评估

LENG Hai-Xia, DING Wei-Jun, ZHANG Wen-Rui,WANG Hong-Xing. Progress in Assessment of Post-stoke Depression[J]. Chinese Journal of Stroke, 2020, 15(07): 795-800.

冷海霞，丁卫军，张文睿，王红星. 卒中后抑郁的评估进展[J]. 中国卒中杂志, 2020, 15(07): 795-800.

References

[1] 张钰，曾丽莉，刘建荣. 警惕脑卒中后早期和晚期抑

郁[J]. 中国现代神经疾病杂志，2015，15（4）：263-

269.

[2] DAS J，G K R. Post stroke depression：the sequelae

of cerebral stroke[J]. Neurosci Biobehav Rev，2018，

90：104-114.

[3] 王红星，张文睿，杨晓桐，等. 深入理解脑卒中后

抑郁的临床状态[J]. 中华医学杂志，2019，99（21）：

1611-1614.

[4] SPALLETTA G，RIPA A，CALTAGIRONE C.

Symptom profile of DSM-Ⅳ major and minor

depressive disorders in first-ever stroke patients[J].

Am J Geriatr Psychiatry，2005，13（2）：108-115.

[5] DE RYCK A，BROUNS R，GEURDEN M，et a1.

Risk factors for post-stroke depression：identification

of inconsistencies based on a systematic review[J]. J

Geriatr Psychiatry Neurol，2014，27（3）：147-158.

[6] 缪学琼，郭建军. 脑卒中后抑郁的危险因素分析[J].

中国实用神经疾病杂志，2016，19（13）：35-36.

[7] 何文龙，余瑞云，薛鹏. 综合心理干预对卒中后抑

郁患者运动功能康复的影响[J]. 临床心身疾病杂志，

2018，24（4）：103-106.

[8] PANCHER P，PICARDI A，PASQUINI M，et al.

Psychopathological dimensions of depression：a

factor study of the 17-item Hamilton depression

rating scale in unipolar depressed outpatients[J]. J

Affect Disord，2002，68（1）：41-47.

[9] GANINOTTI G，AZZONI A，RAZZANO C，et

al. The post-stroke depression rating scale：a test

specifically devised to investigate affective disorders

of stroke patients[J]. J Clin Exp Neuropsychol，1997，

19（3）：340-356.

[10] SPALLETTA G，ROBINSON R G. How should

depression be diagnosed in patients with stroke?[J].

Acta Psychiatr Scand，2010，121（6）：401-403.

[11] MONTGOMERY S A，ÅSBERG M. A new

depression scale designed to be sensitive to

change[J]. Br J Psychiatry，1979，134：382-389.

[12] BECK A T，WARD C H，MENDELSON M，et al.

An inventory for measuring depression[J]. Arch Gen

Psychiatry，1961，4：561-571.

[13] 王振，苑成梅，黄佳，等. 贝克抑郁量表第2版中文

版在抑郁症患者中的信效度[J]. 中国心理卫生杂志，

2011，25（6）：476-480.

[14] ZUNG W W. A rating instrument for anxiety

disorders[J]. Psychosomatics，1971，12（6）：371-379.

[15] ZHANG B S，FOKKEMA M，CUIJPERS P，et

al. Measurement invariance of the Center for

Epidemiological Studies Depression Scale（CES-D）

among Chinese and Dutch elderly[J]. BMC Med Res

Methodol，2011，11：74.

[16] JOHNSTON M，POLLARD B，HENNESSEY P.

Construct validation of the hospital anxiety and

depression scale with clinical populations[J]. J

Psychosom Res，2000，48（6）：579-584.

[17] RUSH A J，TRIVEDI M H，IBRAHIM H M，et

al. The 16-item quick inventory of depressive

symptomatology（QIDS），clinician rating（QIDS-C）and self-report（QIDS-SR）：a psychometric

evaluation in patients with chronic major

depression[J]. Biol psychiatry，2003，54（5）：573-

583.

[18] YESAVAG J A，BRINK T L，ROSE T L，et al.

Development and validation of a geriatric depression

screening scale：a preliminary report[J]. J Psychiatr

Res，1982，17（1）：37-49.

[19] YUE Y Y，LIU R，LU J，et al. Reliability and

validity of a new post-stroke depression scale in

Chinese population[J]. J Affect Disorders，2015，174：

317-323.

[20] KROENKE K，SPITZER R L，WILLIAMS J B.

The PHQ-9 validity of a brief depression severity

measure[J]. J Gen Intern Med，2001，16（9）：606-

613.

[21] KHUBCHANDANI J，BREY R，KOTECKI J，et al.

The psychometric properties of PHQ-4 depression

and anxiety screening scale among college

students[J]. Arch Psychiatr Nurs，2016，30（4）：

457-462.

[22] LINCOLN N B，SUTCLIFFE L M. Validation of the

stroke aphasic depression questionnaire（SADQ）for

use with patients in hospital[J]. Clin Neuropsychol

Assess，1998，12（6）：506-513.

[23] BENAIM C，CAILLY B，PERENNOU D，et al.

Validation of the aphasic depression rating scale[J].

Stroke，2004，35（7）：1692-1696.

[24] COLASANTI V，MATIANETTI M，MICACCHI

F，et al. Tests for the evaluation of depression in

the elderly：a systematic review[J]. Arch Gerontol

Geriatr，2010，50（2）：227-230.

[25] 岳莹莹，袁勇贵. 脑卒中后抑郁的评估和诊断[J]. 实

用老年医学，2015，29（2）：99-103.

[26] WATKINS C，LEATHLEY M，DANIELS L，et al.

The signs of depression scale in stroke：how useful

are nurses' observation?[J]. Clin Rehabil，2001，15：

447-457.

[27] VAN DIJK M J，DE MAN-VAN GINKEL J

M，HAFSTEINSDÓTTIR T B，et al. Identifying

depression post-stroke in patients with aphasia：a

systematic review of the reliability，validity and

feasibility of available instruments[J]. Clin Rehabil，

2016，30（8）：795-810.

[28] TURNER-STOKES L，KALMUS M，HIRANI D，

et al. The Depression Intensity Scale Circles（DISCs）：

a first evaluation of a simple assessment tool for

depression in the context of brain injury[J]. J Neurol

Neurosurg Psychiatry，2005，76（9）：1273-1278.

[29] HUNG C Y F，WU X Y，CHUNG V C H，et al.

Overview of systematic reviews with meta-analyses

on acupuncture in post-stroke cognitive impairment

and depression management[J]. Integr Med Res，

2019，8（3）：145-149.

[30] CHEN Y K，QU J F，XIAO W M，et al. Intracranial

atherosclerosis and poststroke depression in

Chinese patients with ischemic stroke[J]. J Stroke

Cerebrovasc Dis，2016，25（4）：998-1004.

[31] QUARANTA D，MARRA C，GAINOTTI G. Mood

disorders after stroke：diagnostic validation of the

poststroke depression rating scale[J]. Cerebrovasc

Dis，2008，26（3）：237-243.

[32] MATSUZAKI S，HASHIMOTO M，YUKI S，et al.

The relationship between post-stroke depression and

physical recovery[J]. J Affect Disord，2015，176：56-

60.

[33] WILLIAMS L S，BRIZENDINE E J，Plue L，et

al. Performance of the PHQ-9 as a screening tool

for depression after stroke[J]. Stroke，2005，36（3）：

635-638.

[34] 杨海洪. 9条目病人健康问卷抑郁量表在卒中后抑郁

筛查中的应用价值[J]. 实用临床医药杂志，2016，20

（8）：28-30.

[35] BACCARO A，WANG Y P，BRUNONI A R，et

al. Does stroke laterality predict major depression

and cognitive impairment after stroke? Two-year

prospective evaluation in the EMMA study[J]. Prog

Neuropsychopharmacol Biol Psychiatry，2019，94：

109639.

[36] FOURNIER L E，BEAUCHAMP J E S，ZHANG

X，et al. Assessment of the progression of poststroke

depression in ischemic stroke patients using

the patient health questionnaire-9[J]. J Stroke

Cerebrovasc Dis，2020，29（4）：104561.

[37] GHAFFARI A，AKBARFAHIMI M，ROSTAMI

H R. Discriminative factors for post-stroke

depression[J]. Asian J Psychiatr，2020，48：101863.

[38] CHEN C M，LIU X，FANG W J，et al.

Comprehensive rehabilitation training decreases

cognitive impairment，anxiety，and depression

in poststroke patients：a randomized，controlled

study[J]. J Stroke Cerebrovasc Dis，2018，27（10）：

2613-2622.

[39] AYIS S A，AYERBE L，ASHWORTH M，et al.

Evaluation of the Hospital Anxiety and Depression

Scale（HADS）in screening stroke patients for

symptoms：Item Response Theory（IRT）analysis[J].

J Affect Dis，2018，228：33-40.

[40] SARFO F S，JENKINS C，SINGH A，et al. Poststroke

depression in Ghana：characteristics and

correlates[J]. J Neurol Sci，2017，379：261-265.

[41] DE RYCK A，BROUNS R，FRANSEN E，et al. A prospective study on the prevalence and risk factors

of poststroke depression[J]. Cerebrovasc Dis Extra，

2013，3（1）：1-13.

[42] BENAIM C，DECAVEL P，BENTABET M，et al.

Sensitivity to change of two depression rating scales

for stroke patients[J]. Clin Rehabil，2010，24（3）：

251-257.

[43] BALAEV V，ORLOV I，PETRUSHEVSKY A，et

al. Functional connectivity between salience，default

mode and frontoparietal networks in post-stroke

depression[J]. J Affect Disord，2018，227：554-562.

[44] ARRUDA J E，STERN R A，SOMERYILLE J

A. Measurement of mood states in stroke patients：

validation of the visual analogue mood scales[J].

Arch Phys Med Rehabil，1999，80（6）：676-680.

[45] STERN R A，ARRUDA J E，HOOPER C R. et

al. Visual analogue mood scales to measure

internal mood state in neurologically impaired

patients：description and initial validity evidence[J].

Aphasiology，1997，11（1）：59-71.

[46] GAINOTTI G，ANTONUCCI G，MARRA C，

et al. Relation between depression after stroke，

antidepressant therapy，and functional recovery[J].

J Neurol Neurosurg Psychiatry，2001，71（2）：258-

261.

[47] LO COCO D，LOPEZ G，CORRAO S. Cognitive

impairment and stroke in elderly patients[J]. Vasc

Health Risk Manag，2016，12：105-116.

[48] HACKETT M L，PICKLES K. Part Ⅰ：frequency

of depression after stroke：an updated systematic

review and meta-analysis of observational studies[J].

Int J Stroke，2014，9（8）：1017-1025.

[49] KAPOOR A，SCOTT C，LANCTOT K L，et al.

Symptoms of depression and cognitive impairment

in young adults after stroke/transient ischemic

attack[J]. Psychiatry Res，2019，279：361-363.

[50] CAI W，MUELLER C，LI Y J. et al. Post stroke

depression and risk of stroke recurrence and

mortality：a systematic review and meta-analysis[J].

Ageing Res Rev，2019，50：102-109.