Abstract
Depression is a common consequence of stroke and it is known
to be associated with deterioration of quality of life. However,
only limited information is available on the relationships between depression
and communicative and cognitive disorders. Moreover, the present
knowledge of the determinants of the domains of quality of life
is limited, and little is known of e.g. the changes in sexual behaviour
of stroke patients and their spouses. This prospective study was
carried out to evaluate the prevalence of post-stroke depression
and aphasia and to study their interrelationships and neuropsychological
and functional correlates. The particular aim of the study was to
investigate the domain-specific quality of life, and to assess its
clinical and sociodemographic correlates, and to study the impact
of stroke on the sexual functions of stroke patients and their spouses.
The study consisted of 156 first-ever stroke patients.
Depression was diagnosed in 53% of the patients at
3 months and in 42% of the patients at 12 months post-stroke
according to DSM-III-R-criteria. One third of the patients were
aphasic, 70% of them at 3 months and 62% at 12
months after stroke suffering from depression. Among the aphasic patients
the prevalence of major depression increased from 11% to
33% during the 12 months follow-up. There was
an association between post-stroke depression and cognitive impairment,
the domains most likely to be defective being memory, non-verbal
problem solving, and attention and psychomotor speed. The non-verbal
neuropsychological test performance in the aphasic patients was significantly
inferior to that of the patients with dominant hemisphere lesion
without aphasia.
The quality of life of the patients was low at 3 months after
the stroke, and it did not improve during the follow-up of a year.
The test domains most often impaired were Physical functioning,
Physical role limitations, Vitality and General health. Depression,
although mostly minor, and being married emerged as significant
independent contributors to low score value of Vitality and Physical
role limitations. All the analyzed aspects of sexuality were commonly
decreased as a consequence of stroke both in the patients and their
spouses. Nocturnal erections were impaired in 21 (55%)
of the male patients.
The present results demonstrate that more than half of the
patients after stroke suffer from depression and the frequency of
major depression seems to increase over time, especially among the aphasic
patients. Both depression and aphasia increase the liability of
cognitive deficits. Stroke affects various dimensions of quality
of life extensively, and the most important determinants entailing
low quality of life seem to be depression, and, interestingly, being
married. As a part of quality of life, sexual function and satisfaction
with sexual life are impaired both in stroke patients and spouses.
These findings call for multidimensional evaluation of stroke patients
and provide new challenges for stroke rehabilitation.
| Identifer | oai:union.ndltd.org:oulo.fi/oai:oulu.fi:isbn951-42-5427-9 |
| Date | 01 November 1999 |
| Creators | Kauhanen, M.-L. (Marja-Liisa) |
| Publisher | University of Oulu |
| Source Sets | University of Oulu |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/doctoralThesis, info:eu-repo/semantics/publishedVersion |
| Format | application/pdf |
| Rights | info:eu-repo/semantics/openAccess, © University of Oulu, 1999 |
| Relation | info:eu-repo/semantics/altIdentifier/pissn/0355-3221, info:eu-repo/semantics/altIdentifier/eissn/1796-2234 |
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