본문 바로가기
KERD
논문KCI 등재

The Usefulness and Clinical Characteristics of Antidepressant Use for Stroke Patients with Rehabilitation Program: An Exploratory Analysis

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

Objective: There has been a lack of data regarding the usefulness and clinical characteristic between patients-treated with and without antidepressants (Pw/Pwo ADs). Methods: One hundred and eighty inpatients were recruited and observed for a 6-month. The depressive, cognitive, daily activity, and motor symptoms were evaluated at baseline and tracked at month 6, with the use of rating scales including Beck Depression Inventory (BDI), Mini Mental State Examination (MMSE), Global Deterioration Scale (GDS), modified Rankin Scale (MRS), modified Barthel Index (MBI), and Berg Balance Scale (BBS). Results: Among 178 patients, 84 (47.2%) were treated with ADs. PwAD had numerically or significantly higher depressive cognitive, and motor symptoms along with daily activity impairment (8.3 point higher in BDI score, p < 0.001; 3.6 point lower in MMSE, p = 0.003; 0.8 point higher in GDS score, p = nonsignificant; 8.2 point lower in BBS score, p = 0.053, and 0.4 point higher in MBI score, p = nonsignificant) than PwoAD. Psychiatric consultation was also significantly higher in PwAD than in PwoAD (p < 0.001). The numbers need to treat for good clinical outcomes between PwAD and PwoAD were 5.8, 6.0, and 7.5, respectively, by MRS, MBI, and BBS scores. Conclusion: Our findings suggest the potential utility of AD treatment and different clinical parameters between patients- treated with and without ADs. Adequately-powered and well-controlled further studies are mandatory to confirm and fully elaborate such association.

Abstract

Objective: There has been a lack of data regarding the usefulness and clinical characteristic between patients-treated with and without antidepressants (Pw/Pwo ADs). Methods: One hundred and eighty inpatients were recruited and observed for a 6-month. The depressive, cognitive, daily activity, and motor symptoms were evaluated at baseline and tracked at month 6, with the use of rating scales including Beck Depression Inventory (BDI), Mini Mental State Examination (MMSE), Global Deterioration Scale (GDS), modified Rankin Scale (MRS), modified Barthel Index (MBI), and Berg Balance Scale (BBS). Results: Among 178 patients, 84 (47.2%) were treated with ADs. PwAD had numerically or significantly higher depressive cognitive, and motor symptoms along with daily activity impairment (8.3 point higher in BDI score, p < 0.001; 3.6 point lower in MMSE, p = 0.003; 0.8 point higher in GDS score, p = nonsignificant; 8.2 point lower in BBS score, p = 0.053, and 0.4 point higher in MBI score, p = nonsignificant) than PwoAD. Psychiatric consultation was also significantly higher in PwAD than in PwoAD (p < 0.001). The numbers need to treat for good clinical outcomes between PwAD and PwoAD were 5.8, 6.0, and 7.5, respectively, by MRS, MBI, and BBS scores. Conclusion: Our findings suggest the potential utility of AD treatment and different clinical parameters between patients- treated with and without ADs. Adequately-powered and well-controlled further studies are mandatory to confirm and fully elaborate such association.

참고문헌 (23)

  1. Elzib H, "Antidepressant pharmacotherapy and poststroke motor rehabilitation : a review of neurophysiologic mechanisms and clinical relevance", Brain Circ, 5, pp.62~67 (2019)
  2. Chollet F, "Fluoxetine for motor recovery after acute ischaemic stroke(FLAME) : a randomised placebo-controlled trial", Lancet Neurol, 10, pp.123~130 (2011)
  3. Mikami K, "Effect of antidepressants on the course of disability following stroke", Am J Geriatr Psychiatry, 19, pp.1007~1015 (2011)
  4. FOCUS Trial Collaboration, "Effects of fluoxetine on functional outcomes after acute stroke(FOCUS) : a pragmatic, doubleblind, randomised, controlled trial", Lancet, 393, pp.265~274 (2019)
  5. D’Anci KE, "Treatments for poststroke motor deficits and mood disorders: a systematic review for the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense guidelines for stroke rehabilitation", Ann Intern Med, 171, pp.906~915 (2019)
  6. Legg LA, "Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery", Cochrane Database Syst Rev, 2019, pp.CD009286~ (2019)
  7. Beck AT, "An inventory for measuring depression", Arch Gen Psychiatry, 4, pp.561~571 (1961)
  8. Jo SA, "Usefulness of Beck Depression Inventory(BDI)in the Korean elderly population", Int J Geriatr Psychiatry, 22, pp.218~223 (2007)
  9. Shin MS, "The cut-off score for the Korean version of beck depression inventory", Korean J Clin Psychol, 12, pp.71~81 (1993)
  10. Folstein MF, "“Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician", J Psychiatr Res, 12, pp.189~198 (1975)
  11. Reisberg B, "The Global Deterioration Scale for assessment of primary degenerative dementia", Am J Psychiatry, 139, pp.1136~1139 (1982)
  12. van Swieten JC, "Interobserver agreement for the assessment of handicap in stroke patients", Stroke, 19, pp.604~607 (1988)
  13. Granger CV, "Stroke rehabilitation : analysis of repeated Barthel index measures", Arch Phys Med Rehabil, 60, pp.14~17 (1979)
  14. Berg KO, "Measuring balance in the elderly : validation of an instrument", Can J Public Health, 83(Suppl 2), pp.S7~S11 (1992)
  15. Sulter G, "Use of the Barthel index and modified Rankin scale in acute stroke trials", Stroke, 30, pp.1538~1541 (1999)
  16. Mojtabai R, "Increase in antidepressant medication in the US adult population between 1990 and 2003", Psychother Psychosom, 77, pp.83~92 (2008)
  17. Park GY, "The association between the severity of poststroke depression and clinical outcomes after first-onset stroke in Korean patients", Gen Hosp Psychiatry, 37, pp.245~250 (2015)
  18. 박근영, "The Association between Post-Stroke Depression and the Activities of Daily Living", Gait Balance in Patients with First-Onset Stroke Patients, 2016, pp.13(6), 659~664[DOI]
  19. Citrome L, "W When does a difference make a difference? Interpretation of number needed to treat, number needed to harm, and likelihood to be helped or harmed", Int J Clin Pract, 67, pp.407~411 (2013)
  20. Ketter TA, "Treatments for bipolar disorder : can number needed to treat", harm help inform clinical decisions, 2011, pp.123, 175~189
  21. Changsu Han, "The Potential Utility of Aripiprazole Augmentation for Major Depressive Disorder with Mixed Features Specifier: A Retrospective Study", Clinical Psychopharmacology and Neuroscience, 17(4), pp.495~502 (2019), 대한정신약물학회[DOI]
  22. Changsu Han, "A Pharmacogenomic-based Antidepressant Treatment for Patients with Major Depressive Disorder: Results from an 8-week, Randomized, Single-blinded Clinical Trial", Clinical Psychopharmacology and Neuroscience, 16(4), pp.469~480 (2018), 대한정신약물학회[DOI]
  23. Alessandro Serretti, "The Present and Future of Precision Medicine in Psychiatry: Focus on Clinical Psychopharmacology of Antidepressants", Clinical Psychopharmacology and Neuroscience, 16(1), pp.1~6 (2018), 대한정신약물학회[DOI]

관련 논문AI추천

The Association between Post-Stroke Depression and the Activities of Daily Living/Gait Balance in Patients with First-Onset Stroke Patients임선, 박근영, 배치운, 이수정대한신경정신의학회 · PSYCHIATRY INVESTIGATION2016 · 제13권 제6호Differences in Therapeutic Responses and Factors Affecting Post-Stroke Depression at a Later Stage According to Baseline Depression김동억, 장대일, Byung-Chul Lee, Do-Young Kwon, Eun-Jae Lee, Hahn Young Kim, Jae-Kwan Cha, Jei Kim, Ji Hoe Heo, Jin Young Kim, Ji Sung Lee, Jong-Ho Park, Jong S. Kim, Jun Lee, Min-Sun Kim, Sang-Won Park, Seongheon Kim, Seong-Ho Koh, Seong Hwan Ahn, Smi Choi-Kwon, Sung Il Sohn, Woo-Keun Seo대한뇌졸중학회 · 대한뇌졸중영문학회지2018 · 제20권 제2호뇌졸중 환자에서 뇌졸중 후 우울증상의 중증도와 인지기능의 상관관계유승돈, 전민호, 편성범대한재활의학회 · Annals of Rehabilitation Medicine2009 · 제33권 제5호Longitudinal Impact of Depression on Quality of Life in Stroke PatientsEun-Song Kim, Hee-Ju Kang, Jae-Min Kim, Joon-Tae Kim, Ju Wan Kim, Ki-Hyun Cho, Kyung-Yeol Bae, Man-Seok Park, Sung-Wan Kim대한신경정신의학회 · PSYCHIATRY INVESTIGATION2018 · 제15권 제2호The Effect of Post-Stroke Depression on Rehabilitation Outcome and the Impact of Caregiver Type as a Factor of Post-Stroke Depression김영록, 박종범, 안동흔, 이영진, 정지헌대한재활의학회 · Annals of Rehabilitation Medicine2015 · 제39권 제1호뇌졸중 후 우울증손민균대한뇌신경재활학회 · 뇌신경재활2015 · 제8권 제2호

이 간행물의 다른 논문 (14건)