Association between Stroke Status and Depression in a Community Setting: The 2014 Korea National Health and Nutrition Examination Survey
0
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Background and Purpose Previous studies have examined the risk factors for depression in stroke patients, but little information is available on the relationship between stroke status and depression in the community-dwelling general population. We evaluated the association between stroke status and depression using representative nationwide data. Methods In total, 3,487 subjects (aged ≥40 years) who participated in version VI-2 of the sixth Korea National Health and Nutrition Examination Survey (KNHANES) performed in 2014 were included. We compared the prevalence of depression in 120 community-dwelling stroke patients and 3,367 nonstroke controls using the nine-item Patient Health Questionnaire (PHQ-9). Results The prevalence of depression (PHQ-9 score ≥10) was 16.7% in stroke patients and 6.4% in controls. In the unadjusted model, depression was more common in stroke patients than in nonstroke controls [odds ratio (OR), 2.95; 95% confidence interval (CI), 1.79–4.86]. After adjusting for demographic characteristics, socioeconomic status, health-related behaviors, and comorbidities, stroke diagnosis was a significant risk factor for depression (OR, 1.85; 95% CI, 1.06–3.24). Specifically, a diagnosis of stroke in patients aged <60 years (OR, 3.82; 95% CI, 1.81–8.09) and the presence of stroke complications (OR, 2.77; 95% CI, 1.25–6.13) remained significant risk factors for depression even after adjusting for potential confounders. Conclusions In a community setting, poststroke survivors had a higher prevalence of depression, and stroke was an independent risk factor for depression. Public psychosocial interventions are needed to improve the mental health care of community-dwelling stroke survivors.
Abstract
Background and Purpose Previous studies have examined the risk factors for depression in stroke patients, but little information is available on the relationship between stroke status and depression in the community-dwelling general population. We evaluated the association between stroke status and depression using representative nationwide data. Methods In total, 3,487 subjects (aged ≥40 years) who participated in version VI-2 of the sixth Korea National Health and Nutrition Examination Survey (KNHANES) performed in 2014 were included. We compared the prevalence of depression in 120 community-dwelling stroke patients and 3,367 nonstroke controls using the nine-item Patient Health Questionnaire (PHQ-9). Results The prevalence of depression (PHQ-9 score ≥10) was 16.7% in stroke patients and 6.4% in controls. In the unadjusted model, depression was more common in stroke patients than in nonstroke controls [odds ratio (OR), 2.95; 95% confidence interval (CI), 1.79–4.86]. After adjusting for demographic characteristics, socioeconomic status, health-related behaviors, and comorbidities, stroke diagnosis was a significant risk factor for depression (OR, 1.85; 95% CI, 1.06–3.24). Specifically, a diagnosis of stroke in patients aged <60 years (OR, 3.82; 95% CI, 1.81–8.09) and the presence of stroke complications (OR, 2.77; 95% CI, 1.25–6.13) remained significant risk factors for depression even after adjusting for potential confounders. Conclusions In a community setting, poststroke survivors had a higher prevalence of depression, and stroke was an independent risk factor for depression. Public psychosocial interventions are needed to improve the mental health care of community-dwelling stroke survivors.
참고문헌 (28)
- "Causes of Death in South Korea" (2014)[URL]
- 이승원, "Thirty-Year Trends in Mortality from Cardiovascular Diseases in Korea", Korean Circulation Journal, 45(3), pp.202~209 (2015), 대한심장학회
- 김현국, "Mortality Trends of Cardiovascular Disease in Korea; Big Challenges in Ischemic Heart Disease", Korean Circulation Journal, 45(3), pp.192~193 (2015), 대한심장학회
- 방오영, "Considerations When Subtyping Ischemic Stroke in Asian Patients", Journal of Clinical Neurology, 12(2), pp.129~136 (2016), 대한신경과학회[DOI]
- Dafer RM, "Poststroke depression", Top Stroke Rehabil, 15, pp.13~21 (2008)
- Espárrago Llorca G, "Post-stroke depression: an update", Neurologia, 30, pp.23~31 (2015)
- Pohjasvaara T, "Depression is an independent predictor of poor long-term functional outcome post-stroke", Eur J Neurol, 8, pp.315~319 (2001)
- Hackett ML, "Predictors of depression after stroke: a systematic review of observational studies", Stroke, 36, pp.2296~2301 (2005)
- Kroenke K, "The PHQ-9: validity of a brief depression severity measure", J Gen Intern Med, 16, pp.606~613 (2001)
- Gilbody S, "Screening for depression in medical settings with the Patient Health Questionnaire (PHQ): a diagnostic meta-analysis", J Gen Intern Med, 22, pp.1596~1602 (2007)
- de Man-van Ginkel JM, "Screening for poststroke depression using the patient health questionnaire", Nurs Res, 61, pp.333~341 (2012)
- Burton LJ, "Screening for mood disorders after stroke: a systematic review of psychometric properties and clinical utility", Psychol Med, 45, pp.29~49 (2015)
- Srivastava A, "Post-stroke depression:prevalence and relationship with disability in chronic stroke survivors", Ann Indian Acad Neurol, 13, pp.123~127 (2010)
- Carod-Artal FJ, "Poststroke depression: prevalence and determinants in Brazilian stroke patients", Cerebrovasc Dis, 28, pp.157~165 (2009)
- Lam SC, "Depressive symptoms among communitydwelling, post-stroke elders in Hong Kong", Int Nurs Rev, 57, pp.269~273 (2010)
- Sienkiewicz-Jarosz H, "Predictors of depressive symptoms in patients with stroke - a three-month follow-up", Neurol Neurochir Pol, 44, pp.13~20 (2010)
- Kweon S, "Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES)", Int J Epidemiol, 43, pp.69~77 (2014)
- Hackett ML, "Part I: frequency of depression after stroke:an updated systematic review and meta-analysis of observational studies", Int J Stroke, 9, pp.1017~1025 (2014)
- Ayerbe L, "Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis", Br J Psychiatry, 202, pp.14~21 (2013)
- Robinson RG, "Post-stroke depression: a review", Am J Psychiatry, 173, pp.221~231 (2016)
- Chollet F, "Fluoxetine for motor recovery after acute ischaemic stroke (FLAME):a randomised placebo-controlled trial", Lancet Neurol, 10, pp.123~130 (2011)
- Jorge RE, "Escitalopram and enhancement of cognitive recovery following stroke", Arch Gen Psychiatry, 67, pp.187~196 (2010)
- Ried LD, "Selective serotonin reuptake inhibitor treatment and depression are associated with poststroke mortality", Ann Pharmacother, 45, pp.888~897 (2011)
- Hackett ML, "Neuropsychiatric outcomes of stroke", Lancet Neurol, 13, pp.525~534 (2014)
- Ayerbe L, "The long-term outcomes of depression up to 10 years after stroke; the South London Stroke Register", J Neurol Neurosurg Psychiatry, 85, pp.514~521 (2014)
- Kutlubaev MA, "Part II: predictors of depression after stroke and impact of depression on stroke outcome: an updated systematic review of observational studies", Int J Stroke, 9, pp.1026~1036 (2014)
- Park SJ, "Sociodemographic factors associated with the use of mental health services in depressed adults:results from the Korea National Health and Nutrition Examination Survey (KNHANES)", BMC Health Serv Res, 14, pp.645~ (2014)
- Yoon JH, "Occupational noise annoyance linked to depressive symptoms and suicidal ideation: a result from nationwide survey of Korea", PLoS One, 9, pp.e105321~ (2014)